Transforaminal endoscopic spinal surgery: The future ‘gold standard’ for discectomy? – A review

Abstract Background Lumbar disc prolapse is common and the primary method of care in most centres is still open discectomy facilitated by microscope or loupe magnification and illumination. Hospitalisation may be less than 24 h, but post-operative pain usually requires an overnight stay. This review...

Full description

Saved in:
Bibliographic Details
Published in:The surgeon (Edinburgh) 2012-10, Vol.10 (5), p.290-296
Main Authors: Gibson, J.N. Alastair, Cowie, Jonathan G, Iprenburg, Menno
Format: Article
Language:English
Subjects:
Cost Savings
Discectomy
Diskectomy - economics
Diskectomy - methods
Endoscopic
Endoscopy - economics
Endoscopy - methods
Humans
Intervertebral Disc Displacement - economics
Intervertebral Disc Displacement - surgery
Learning Curve
Lumbar Vertebrae
Microdiscectomy
Operating Rooms
Patient Satisfaction
Return to Work - statistics & numerical data
Surgery
Trans-foraminal
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Lumbar disc prolapse is common and the primary method of care in most centres is still open discectomy facilitated by microscope or loupe magnification and illumination. Hospitalisation may be less than 24 h, but post-operative pain usually requires an overnight stay. This review describes transforaminal endoscopic spinal surgery (TESS) using HD-video technology, that is generally performed as a day case procedure under sedation or light general anaesthesia, and collates the evidence comparing the technique to microdiscectomy. Methods The method of TESS is described and an electronic literature search performed to identify papers reporting clinical outcomes. International data were translated where necessary and proceedings' abstracts included. In addition, papers held by the authors and colleagues in personal libraries were carefully cross-referenced to the obtained database. Results Analysis of the data supports the use of a transforaminal endoscopic approach to the lumbar intervertebral disc and suggests that outcomes following surgery are at least equivalent to those following microdiscectomy. Significant cost-savings in terms of in-patient stay may be generated. In addition, there is also some evidence supporting endoscopic surgery for relief of foraminal stenosis. Conclusion Based on current evidence there are good arguments supporting a more wide-spread adoption of transforaminal endoscopic surgery for the treatment of lumbar disc prolapse with or without foraminal stenosis.
ISSN:1479-666X
2405-5840
DOI:10.1016/j.surge.2012.05.001