1.Strategies for Noncontained Lumbar Disc Herniation by an Endoscopic Approach : Transforaminal Suprapedicular Approach, Semi-Rigid Flexible Curved Probe, and 3-Dimensional Reconstruction CT with Discogram.
Ki Hwan CHAE ; Chang Il JU ; Seung Myung LEE ; Byoung Wook KIM ; Saeng Youp KIM ; Hyeun Sung KIM
Journal of Korean Neurosurgical Society 2009;46(4):312-316
OBJECTIVE: The purpose of this study was to evaluate the efficacy of a transforaminal suprapedicular approach, semi-rigid flexible curved probe, and 3-dimensional reconstruction computed tomography (3D-CT) with discogram in the endoscopic treatment of non-contained lumbar disc herniations. METHODS: The subjects were 153 patients with difficult, non-contained lumbar disc herniations undergoing endoscopic treatment. The types of herniation were as follows : extraforaminal, 17 patients; foraminal, 21 patients; high grade migration, 59 patients; and high canal compromise, 56 patients. To overcome the difficulties in endoscopic treatment, the anatomic structures were analyzed by 3D reconstruction CT and the high grade disc was extracted using a semi-rigid flexible curved probe and a transforaminal suprapedicular approach. RESULTS: The mean follow-up was 18.3 months. The mean visual analogue scale (VAS) of the patients prior to surgery was 9.48, and the mean postoperative VAS was 1.63. According to Macnab's criteria, 145 patients had excellent and good results, and thus satisfactory results were obtained in 94.77% cases. CONCLUSION: In a posterolateral endoscopic lumbar discectomy, the difficult, non-contained disc is considered to be the most important factor impeding the success of surgery. By applying a semi-rigid flexible curved probe and using a transforaminal suprapedicular approach, good surgical results can be obtained, even in high grade, non-contained disc herniations.
Diskectomy
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Diskectomy, Percutaneous
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Follow-Up Studies
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Humans
2.Far Lateral Extraforaminal Disc Herniation after Percutaneous Laser Lumbar Discectomy.
Byoung Jun KONG ; Koang Hum BAK ; Seung Hoon OH ; Jae Min KIM ; Choong Hyun KIM ; Nam Kyu KIM
Journal of Korean Neurosurgical Society 1997;26(11):1614-1617
The authors report a case of far lateral disc herniation at L4-5 found one year after percutaneous laser lumbar discectomy. The patient was found to be suffering from new-onset right lumbar radiculopathy 6 months after his first operation, and post operative lumbar MRI confirmed a far lateral extraforaminal disc herniation at L4-5, with compression of the nerve. This corresponded to the nucleotomy site of the probe. The patient underwent surgery employng the combined paraspinal intertransverse and interlaminar approach, and his symptoms were relieved. This case emphasizes the importance of removing nuclear material, and shows that remaining material can herniate through a percutaneous discectomy window.
Diskectomy*
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Diskectomy, Percutaneous
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Humans
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Magnetic Resonance Imaging
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Radiculopathy
3.Clinical Experience of Automated Percutaneous Lumbar Discectomy.
Won Sik CHOY ; Whan Jeung KIM ; Nam Hun KIM ; Kyu Hyun KIM ; Dae Hwa SONG
Journal of Korean Society of Spine Surgery 1997;4(1):149-156
No abstract available.
Diskectomy*
4.Operative Treatment of Lumbar Disc Herniation.
Journal of Korean Society of Spine Surgery 2001;8(3):327-335
Operative methods are changing from aggressive open methods to less invasive methods including microscopic discectomy and various kinds of percutaneous methods. In spite of having definite advantages, percutaneous methods still have limited indications and no uniformly convincing clinical results. Microscopic discectomy has advantages of those of open methods and percutaneous methods. A review of clinical results of operative treatment for lumbar disc herniation shows favorable long-term results. For the better long-term results, we should understand the proper indications of each treatment modalities.
Diskectomy
5.Responses to the Letter: Cervical Foraminal and Discal Height after Dynamic Rotational Plating in the Cervical Discectomy and Fusion.
Jin Oh PARK ; Moon Soo PARK ; Seong Hwan MOON ; In Sung KIM ; Seok Woo KIM ; Yong Chan KIM ; Tae Hwan KIM ; Bo Kyung SUH ; Ji Hoon NAM ; Hwan Mo LEE
Asian Spine Journal 2016;10(2):405-405
No abstract available.
Diskectomy*
6.Transthoracic-Extrapleural Approach for Microsurgical Thoracic Discectomy with Video Assistance: Technical Report of Three Cases.
Sang Ho LEE ; Sang Hyeop JEON ; Jong Yeul CHOI ; Ho Yeon LEE ; Byung Joo JUNG ; Sang Rak LIM
Journal of Korean Neurosurgical Society 2000;29(12):1677-1681
No abstract available.
Diskectomy*
7.Thoracoscopic Discectomy of the Herniated Thoracic Discs.
Sang Ho LEE ; Sang Rak LIM ; Ho Yeon LEE ; Sang Hyeop JEON ; Young Mi HAN ; Byung Joo JUNG
Journal of Korean Neurosurgical Society 2000;29(12):1577-1583
No abstract available.
Diskectomy*
8.Herniated Lumbar Discs Treated with Conventional Open Surgery after the Failure of Laser Discectomy: Report of Three Cases.
Young Jun KWON ; Gook Ki KIM ; Young Jin LIM ; Tae Sung KIM ; Bong Am RHEE ; Won LEEM
Journal of Korean Neurosurgical Society 1997;26(8):1139-1144
Thepercutaneous treatmentof lumbardisc diseasewithlaser energyhas recently emerged as an alternative to standard open surgery or mechanical percutaneous methods. The indications of percutaneousendoscopic laser discectomy should, however, be well evaluated according to clinical and morphological criteria. We report three cases of herniated lumbar disc treated with conventional open surgery after the failure of laser discectomy.
Diskectomy*
9.Comparison of results in automated percutaneous lumbar diecetomy versus open discectomy.
Duck Yun CHO ; Jae Gon SEO ; Eung Ha KIM ; Hwan Cheon HWANG
The Journal of the Korean Orthopaedic Association 1992;27(3):658-669
No abstract available.
Diskectomy*
10.Use of Lidocaine Patch for Percutaneous Endoscopic Lumbar Discectomy.
The Korean Journal of Pain 2011;24(2):74-80
BACKGROUND: Lidocaine patch (L5P) has demonstrated short-term efficacy in treating both acute surgical pain and chronic neuropathic pain with tolerable side effects. Percutaneous endoscopic lumbar discectomy (PELD) is the mainstay of minimally invasive spine surgery (MISS). Sufficient analgesia during PELD surgery makes the patient consider it real MISS. This study was performed to evaluate the efficacy and adverse effects of lidocaine patch in patients who underwent PELD under local anesthesia. METHODS: L5P (L group) or placebo (P group) was randomly applied on the skin of the back covering the anticipated path of the working channel before 1 hour of surgery in 100 patients who underwent a single level PELD at L4-L5. Efficacy of the lidocaine patch was assessed by patient's numeric rating scale (NRS) of pain at each stage during the surgery and by a 5-scale grading of the satisfaction with the anesthesia of the operator and patients after surgery. RESULTS: Mean NRS scores at the stages of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture were significantly lower in the L group than the P group. Postoperative operator's and patients' satisfaction scores were also significantly higher in L group than in the P group. There were subtle adverse effects in both groups. CONCLUSIONS: L5P provided better pain relief during PELD, especially at the stage of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture. It also provided higher patient and operator postoperative satisfaction, with only subtle adverse effects.
Analgesia
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Anesthesia
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Diskectomy
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Diskectomy, Percutaneous
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Endoscopy
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Humans
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Lidocaine
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Needles
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Neuralgia
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Skin
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Spine
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Sutures
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Transdermal Patch