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Morimoto M, Tamaki S, Ogawa T, Fujimoto S, Sugiura K, Takeuchi M, Manabe H, Tezuka F, Yamashita K, Fujitani J, Sairyo K. Advantages of Full-endoscopic Trans-Kambin's Triangle Lumbar Interbody Fusion for Degenerative Spondylolisthesis: Illustrative Cases. NMC Case Rep J 2023; 10:87-92. [PMID: 37131495 PMCID: PMC10149142 DOI: 10.2176/jns-nmc.2022-0287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/28/2022] [Indexed: 05/04/2023] Open
Abstract
Various approaches to lumbar interbody fusion have been described. The usefulness of full-endoscopic trans-Kambin's triangle lumbar interbody fusion has recently been reported. This technique has several advantages in patients with degenerative spondylolisthesis, including the ability to improve symptoms without decompression surgery. Moreover, given that the entire procedure is performed percutaneously, it can be performed without increasing the operation time or surgical invasiveness, even in obese patients. In this article, we discuss these advantages and illustrate them with representative cases.
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Affiliation(s)
- Masatoshi Morimoto
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Shunsuke Tamaki
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Takayuki Ogawa
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Shutaro Fujimoto
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Kosuke Sugiura
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Makoto Takeuchi
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Hiroaki Manabe
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Fumitake Tezuka
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Kazuta Yamashita
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Junzo Fujitani
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
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OKADA R, SAKAI T, NISHISHO T, NITTA A, TAKAHARA S, OBA K, SAIRYO K. Preoperative Planning Using Three-dimensional Printing for Full-endoscopic Spine Surgery: A Technical Note. NMC Case Rep J 2022; 9:249-253. [PMID: 36128054 PMCID: PMC9458159 DOI: 10.2176/jns-nmc.2022-0077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/13/2022] [Indexed: 12/04/2022] Open
Abstract
Transforaminal full-endoscopic spine surgery (TF-FESS) is a novel minimally invasive spine surgery that requires only an 8-mm skin incision and causes minimal damage to the paravertebral muscles. To perform TF-FESS safely and efficiently, preoperative planning is quite important as the intervention requires anatomical understanding and high technical skills. Recently, three-dimensional (3D) printing has become a useful tool in various surgeries, and several studies have addressed its efficacy; however, there are no reports on the application of 3D printing to FESS. In this study, we present two cases of severe lumbar deformities for which preoperative 3D printing was useful. The 3D printing enabled the surgeons to visualize and plan the drilling of the superior articular process for a successful foraminoplasty at a low cost. The manufacturing equipment cost about USD 900 and is able to produce an actual-size model at a cost of less than USD 10 per patient. In conclusion, preoperative planning using 3D printing should be adopted to safely perform FESS.
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Affiliation(s)
- Ryo OKADA
- Tokushima Prefectural Miyoshi Hospital
| | - Toshinori SAKAI
- Department of Orthopedics, Tokushima University Graduate School
| | | | | | | | | | - Koichi SAIRYO
- Department of Orthopedics, Tokushima University Graduate School
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Sugiyama K, Harada N, Kondo K, Wada A, Takahashi H, Sugo N. Relationship between Preoperative Neuroradiological Findings and Intraoperative Bulbocavernosus Reflex Amplitude in Patients with Intradural Extramedullary Tumors. Neurol Med Chir (Tokyo) 2021; 61:484-491. [PMID: 34078828 PMCID: PMC8365236 DOI: 10.2176/nmc.oa.2020-0425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The current study aimed to evaluate the relationship between preoperative neuroradiological findings and intraoperative bulbocavernosus reflex (BCR) amplitude in patients with intradural extramedullary tumors. A total of 24 patients with lesions below the 12th thoracic vertebra were included in the analysis. Objective and subjective urinary symptoms were investigated using data obtained from medical records and the core lower urethral symptom score (CLSS) questionnaire. The lesion compression rate was evaluated with MRI. In the epiconus-to-conus medullaris (Epi-CM) group, BCR amplitude changes were found to be correlated with the compression rate (p <0.05). The preoperative CLSS of the group with a BCR amplitude of <50% was worse than that of the group with ≥50% (p <0.01). The group did not experience symptom improvement 6 months postoperatively based on the CLSS. The preoperative CLSS of the group with compression rate of ≥80% on imaging was worse than that of the group with <80% (p <0.05). In the group with preoperative compression rate of ≥80%, CLSS at 1 month and 6 months postoperatively was improved as compared to preoperative CLSS (p <0.01, p <0.05). Hence, BCR amplitude changes are associated with the degree of lesion compression on preoperative images and pre- and postoperative urinary symptoms. Patients with intradural extramedullary Epi-CM lesions with strong compression are likely to present with low BCR amplitude and worsened postoperative symptoms. It is considered that the risk of postoperative urinary symptoms increases even with careful surgical manipulation under these conditions.
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Affiliation(s)
- Kunio Sugiyama
- Department of Neurosurgery, Toho University Graduate School of Medicine
| | - Naoyuki Harada
- Department of Neurosurgery, School of Medicine, Faculty of Medicine, Toho University
| | - Kosuke Kondo
- Department of Neurosurgery, School of Medicine, Faculty of Medicine, Toho University
| | - Akihito Wada
- Department of Orthopedic Surgery, Toho University School of Medicine
| | - Hiroshi Takahashi
- Department of Orthopedic Surgery, Toho University School of Medicine
| | - Nobuo Sugo
- Department of Neurosurgery, Toho University Graduate School of Medicine.,Department of Neurosurgery, School of Medicine, Faculty of Medicine, Toho University
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