Contralateral Sublaminar Endoscopic Approach for Removal of Lumbar Juxtafacet Cysts Using Percutaneous Biportal Endoscopic Surgery: Technical Report and Preliminary Results.
Cyst
Facet joint
Lumbar
Minimally invasive surgery
Stenosis
Surgical decompression
Surgical endoscopy
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
02
10
2018
revised:
07
11
2018
accepted:
08
11
2018
pubmed:
21
11
2018
medline:
21
3
2019
entrez:
21
11
2018
Statut:
ppublish
Résumé
Use of a contralateral sublaminar endoscopic approach may minimize facet violation and better visualize the dura and cystic lesions during operation. The aim of this study was to introduce a surgical technique for contralateral sublaminar endoscopic removal of lumbar juxtafacet cysts using a percutaneous biportal endoscopic approach. Ten cases of lumbar juxtafacet cyst were consecutively treated via a contralateral sublaminar endoscopic approach using percutaneous biportal endoscopic surgery. Postoperative magnetic resonance imaging scans were evaluated on postoperative day 1 for optimal removal of cysts and neural decompression status. Clinical findings were evaluated in preoperative and postoperative periods using a visual analog scale for leg pain and the Oswestry Disability Index. Ten lumbar juxtafacet cysts in 10 patients were treated using the contralateral sublaminar biportal endoscopic approach. Postoperative magnetic resonance imaging depicted complete removal of juxtafacet cysts and optimal neural decompression of treated segments in all patients. Preoperative visual analog scale and Oswestry Disability Index scores improved significantly after surgery: visual analog scale scores changed from 7.64 ± 0.71 preoperatively to 1.63 ± 1.28 at last follow-up visit (P < 0.05), and Oswestry Disability Index scores changed from 45.35 ± 16.15 to 15.82 ± 10.21 (P < 0.05). Mean operative time was 60.1 ± 23.4 minutes. A contralateral sublaminar approach using percutaneous biportal endoscopy may be an alternative treatment for symptomatic lumbar juxtafacet cysts. This approach may minimize iatrogenic facet violation and traumatization of posterior musculoligamentous structures.
Sections du résumé
BACKGROUND
BACKGROUND
Use of a contralateral sublaminar endoscopic approach may minimize facet violation and better visualize the dura and cystic lesions during operation. The aim of this study was to introduce a surgical technique for contralateral sublaminar endoscopic removal of lumbar juxtafacet cysts using a percutaneous biportal endoscopic approach.
METHODS
METHODS
Ten cases of lumbar juxtafacet cyst were consecutively treated via a contralateral sublaminar endoscopic approach using percutaneous biportal endoscopic surgery. Postoperative magnetic resonance imaging scans were evaluated on postoperative day 1 for optimal removal of cysts and neural decompression status. Clinical findings were evaluated in preoperative and postoperative periods using a visual analog scale for leg pain and the Oswestry Disability Index.
RESULTS
RESULTS
Ten lumbar juxtafacet cysts in 10 patients were treated using the contralateral sublaminar biportal endoscopic approach. Postoperative magnetic resonance imaging depicted complete removal of juxtafacet cysts and optimal neural decompression of treated segments in all patients. Preoperative visual analog scale and Oswestry Disability Index scores improved significantly after surgery: visual analog scale scores changed from 7.64 ± 0.71 preoperatively to 1.63 ± 1.28 at last follow-up visit (P < 0.05), and Oswestry Disability Index scores changed from 45.35 ± 16.15 to 15.82 ± 10.21 (P < 0.05). Mean operative time was 60.1 ± 23.4 minutes.
CONCLUSIONS
CONCLUSIONS
A contralateral sublaminar approach using percutaneous biportal endoscopy may be an alternative treatment for symptomatic lumbar juxtafacet cysts. This approach may minimize iatrogenic facet violation and traumatization of posterior musculoligamentous structures.
Identifiants
pubmed: 30458327
pii: S1878-8750(18)32620-2
doi: 10.1016/j.wneu.2018.11.072
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
474-479Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.