J Korean Orthop Assoc.  2019 Jun;54(3):219-226. 10.4055/jkoa.2019.54.3.219.

Biportal Percutaneous Endoscopic Spinal Surgery for Lumbar Spinal Stenosis

• Kang T
• Lee SH
• Park SY

• KMID: 2450141
• DOI: http://doi.org/10.4055/jkoa.2019.54.3.219

Abstract

Lumbar decompressive surgery is a standard surgery for lumbar spinal stenosis. Many surgical techniques have been introduced, ranging from open surgery to percutaneous procedures. Minimally invasive techniques are preferred because of the less postoperative pain and shorter hospital stay. Uniportal percutaneous endoscopic decompression has technical difficulties due to the narrow field. Biportal percutaneous endoscopic decompression is a satisfactory technique that can compensate for the shortcomings and provide sufficient decompression.

Keyword

spinal stenosis; endoscopy; minimally invasive surgery

MeSH Terms

Decompression
Endoscopy
Ion Transport
Length of Stay
Minimally Invasive Surgical Procedures
Pain, Postoperative
Spinal Stenosis*

Figure

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  Figure 1. Kambin’s triangle: the exiting root is the hypotenuse, the superior border of the lower vertebral body is the base, and the height is the superior articular facet.

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  Figure 2. Uniportal endoscopic surgery has restricted vision and technical difficulties because all the instruments use a single portal.

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  Figure 3. Portal placement of the biportal arthroscopic approach: two separate 1 cm vertical incisions were made obliquely. Arrows: disc protrusion.

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  Figure 4. One portal is used for arthroscopic viewing and continuous irrigation, and the other is used for the insertion and manipulation of instruments. Saline inflow through cranial viewing portal, and outflow through the caudal working portal allows continuous irrigation.

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  Figure 5. Intraoperative arthroscopic view: standard arthroscopic instruments and conventional spinal instruments are used, such as Kerrison rongeur, high speed burr, pituitary forceps, and curette.

Reference

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