Skip to main content
Top
Published in: International Orthopaedics 4/2019

01-04-2019 | Cervical Disc Herniation | Review Article

Endoscopic spine discectomy: indications and outcomes

Author: Yong Ahn

Published in: International Orthopaedics | Issue 4/2019

Login to get access

Abstract

Purpose

Percutaneous endoscopic discectomy is an effective minimally invasive spine surgery (MISS) for soft disc herniations. The objective of this review was to describe the current indications, surgical techniques, and clinical outcomes of endoscopic spine surgery.

Methods

A narrative review was performed with a focus on surgical indication of percutaneous endoscopic discectomy and the clinical outcomes in lumbar and cervical spine. Percutaneous endoscopic or full-endoscopic discectomy using a working channel endoscope was described.

Results

The basic principles, surgical techniques, and clinical outcomes in lumbar and cervical disc herniations were demonstrated. For the lumbar disc herniation (LDH), transforaminal and interlaminar approaches were reviewed, whereas for the cervical disc herniation (CDH), anterior and posterior approaches were reviewed.

Conclusions

Endoscopic spine surgery for soft disc herniation can be effective with benefits of minimal tissue trauma in properly selected cases. Given the recent technical advancements, the surgical indications for endoscopic spine surgery are still expanding and the clinical results have become more practical and reliable.
Literature
3.
go back to reference Hijikata S (1989) Percutaneous nucleotomy. A new concept technique and 12 years’ experience. Clin Orthop 238:9–23CrossRef Hijikata S (1989) Percutaneous nucleotomy. A new concept technique and 12 years’ experience. Clin Orthop 238:9–23CrossRef
4.
go back to reference Kambin P, Sampson S (1986) Posterolateral percutaneous suction-excision of herniated lumbar intervertebral discs. Report of interim results. Clin Orthop Relat Res 207:37–43 Kambin P, Sampson S (1986) Posterolateral percutaneous suction-excision of herniated lumbar intervertebral discs. Report of interim results. Clin Orthop Relat Res 207:37–43
8.
go back to reference Kambin P, O'Brien E, Zhou L, Schaffer JL (1998) Arthroscopic microdiscectomy and selective fragmentectomy. Clin Orthop Relat Res 347:150–167CrossRef Kambin P, O'Brien E, Zhou L, Schaffer JL (1998) Arthroscopic microdiscectomy and selective fragmentectomy. Clin Orthop Relat Res 347:150–167CrossRef
9.
go back to reference Yeung AT, Tsou PM (2002) Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976) 27:722–731CrossRef Yeung AT, Tsou PM (2002) Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976) 27:722–731CrossRef
10.
go back to reference Onik G, Helms CA, Ginsberg L, Hoaglund FT, Morris J (1985) Percutaneous lumbar diskectomy using a new aspiration probe: porcine and cadaver model. Radiology 155:251–252CrossRefPubMed Onik G, Helms CA, Ginsberg L, Hoaglund FT, Morris J (1985) Percutaneous lumbar diskectomy using a new aspiration probe: porcine and cadaver model. Radiology 155:251–252CrossRefPubMed
11.
go back to reference Onik G, Maroon J, Helms C et al (1987) Automated percutaneous diskectomy: initial patient experience. Work in progress. Radiology 162:129–132CrossRefPubMed Onik G, Maroon J, Helms C et al (1987) Automated percutaneous diskectomy: initial patient experience. Work in progress. Radiology 162:129–132CrossRefPubMed
12.
go back to reference Maroon JC, Onik G (1987) Percutaneous automated discectomy: a new method for lumbar disc removal. Technical note. J Neurosurg 66:143–146CrossRefPubMed Maroon JC, Onik G (1987) Percutaneous automated discectomy: a new method for lumbar disc removal. Technical note. J Neurosurg 66:143–146CrossRefPubMed
13.
14.
go back to reference Hausmann B, Forst R (1983) Nucleoscope . Instrumentarium for endoscopy of the intervertebral disc space. Arch Orthop Trauma Surg 102:57–59CrossRefPubMed Hausmann B, Forst R (1983) Nucleoscope . Instrumentarium for endoscopy of the intervertebral disc space. Arch Orthop Trauma Surg 102:57–59CrossRefPubMed
15.
go back to reference Schreiber A, Suezawa Y (1986) Transdiscoscopic percutaneous nucleotomy in disk herniation. Orthop Rev 15:35–38PubMed Schreiber A, Suezawa Y (1986) Transdiscoscopic percutaneous nucleotomy in disk herniation. Orthop Rev 15:35–38PubMed
16.
go back to reference Mayer HM, Brock M (1993) Percutaneous endoscopic lumbar discectomy (PELD). Neurosurg Rev 16:115–120CrossRefPubMed Mayer HM, Brock M (1993) Percutaneous endoscopic lumbar discectomy (PELD). Neurosurg Rev 16:115–120CrossRefPubMed
17.
18.
go back to reference Ditsworth DA (1998) Endoscopic transforaminal lumbar discectomy and reconfiguration: a postero-lateral approach into the spinal canal. Surg Neurol 49:588–597 discussion 597-598CrossRefPubMed Ditsworth DA (1998) Endoscopic transforaminal lumbar discectomy and reconfiguration: a postero-lateral approach into the spinal canal. Surg Neurol 49:588–597 discussion 597-598CrossRefPubMed
19.
go back to reference Ruetten S, Komp M, Godolias G (2006) A new full-endoscopic technique for the interlaminar operation of lumbar disc herniations using 6-mm endoscopes: prospective 2-year results of 331 patients. Minim Invasive Neurosurg 49:80–87CrossRefPubMed Ruetten S, Komp M, Godolias G (2006) A new full-endoscopic technique for the interlaminar operation of lumbar disc herniations using 6-mm endoscopes: prospective 2-year results of 331 patients. Minim Invasive Neurosurg 49:80–87CrossRefPubMed
20.
go back to reference Tajima T, Sakamoto H, Yamakawa H (1989) Diskectomy cervical percutanee. Revue Med Orthoped 17:7–10 Tajima T, Sakamoto H, Yamakawa H (1989) Diskectomy cervical percutanee. Revue Med Orthoped 17:7–10
21.
go back to reference Courtheoux F, Theron J (1992) Automated percutaneous nucleotomy in the treatment of cervicobrachial neuralgia due to disc herniation. J Neuroradiol 19:211–216PubMed Courtheoux F, Theron J (1992) Automated percutaneous nucleotomy in the treatment of cervicobrachial neuralgia due to disc herniation. J Neuroradiol 19:211–216PubMed
22.
go back to reference Bonaldi G, Minonzio G, Belloni G et al (1994) Percutaneous cervical diskectomy: preliminary experience. Neuroradiology 36:483–486CrossRefPubMed Bonaldi G, Minonzio G, Belloni G et al (1994) Percutaneous cervical diskectomy: preliminary experience. Neuroradiology 36:483–486CrossRefPubMed
23.
go back to reference Hoogland T, Scheckenbach C (1995) Low-dose chemonucleolysis combined with percutaneous nucleotomy in herniated cervical disks. J Spinal Disord 8:228–232CrossRefPubMed Hoogland T, Scheckenbach C (1995) Low-dose chemonucleolysis combined with percutaneous nucleotomy in herniated cervical disks. J Spinal Disord 8:228–232CrossRefPubMed
24.
go back to reference Knight MT, Goswami A, Patko JT (2001) Cervical percutaneous laser disc decompression: preliminary results of an ongoing prospective outcome study. J Clin Laser Med Surg 19:3–8CrossRefPubMed Knight MT, Goswami A, Patko JT (2001) Cervical percutaneous laser disc decompression: preliminary results of an ongoing prospective outcome study. J Clin Laser Med Surg 19:3–8CrossRefPubMed
25.
go back to reference Laing RJ, Ng I, Seeley HM, Hutchinson PJ (2001) Prospective study of clinical and radiological outcome after anterior cervical discectomy. Br J Neurosurg 15:319–323CrossRefPubMed Laing RJ, Ng I, Seeley HM, Hutchinson PJ (2001) Prospective study of clinical and radiological outcome after anterior cervical discectomy. Br J Neurosurg 15:319–323CrossRefPubMed
26.
go back to reference Ahn Y, Lee SH, Lee SC, Shin SW, Chung SE (2004) Factors predicting excellent outcome of percutaneous cervical discectomy: analysis of 111 consecutive cases. Neuroradiology 46:378–384CrossRefPubMed Ahn Y, Lee SH, Lee SC, Shin SW, Chung SE (2004) Factors predicting excellent outcome of percutaneous cervical discectomy: analysis of 111 consecutive cases. Neuroradiology 46:378–384CrossRefPubMed
27.
go back to reference Chiu JC, Clifford TJ, Greenspan M et al (2000) Percutaneous microdecompressive endoscopic cervical discectomy with laser thermodiskoplasty. Mt Sinai J Med 67:278–282PubMed Chiu JC, Clifford TJ, Greenspan M et al (2000) Percutaneous microdecompressive endoscopic cervical discectomy with laser thermodiskoplasty. Mt Sinai J Med 67:278–282PubMed
28.
go back to reference Ahn Y, Lee SH, Chung SE, Park HS, Shin SW (2005) Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation. Neuroradiology 47:924–930CrossRefPubMed Ahn Y, Lee SH, Chung SE, Park HS, Shin SW (2005) Percutaneous endoscopic cervical discectomy for discogenic cervical headache due to soft disc herniation. Neuroradiology 47:924–930CrossRefPubMed
29.
go back to reference Ahn Y, Lee SH, Shin SW (2005) Percutaneous endoscopic cervical discectomy: clinical outcome and radiographic changes. Photomed Laser Surg 23:362–368CrossRefPubMed Ahn Y, Lee SH, Shin SW (2005) Percutaneous endoscopic cervical discectomy: clinical outcome and radiographic changes. Photomed Laser Surg 23:362–368CrossRefPubMed
30.
go back to reference Grieve JP, Kitchen ND, Moore AJ, Marsh HT (2000) Results of posterior cervical foraminotomy for treatment of cervical spondylitic radiculopathy. Br J Neurosurg 14:40–43CrossRefPubMed Grieve JP, Kitchen ND, Moore AJ, Marsh HT (2000) Results of posterior cervical foraminotomy for treatment of cervical spondylitic radiculopathy. Br J Neurosurg 14:40–43CrossRefPubMed
31.
go back to reference O'Toole JE, Sheikh H, Eichholz KM, Fessler RG, Perez-Cruet MJ (2006) Endoscopic posterior cervical foraminotomy and discectomy. Neurosurg Clin N Am 17:411–422CrossRefPubMed O'Toole JE, Sheikh H, Eichholz KM, Fessler RG, Perez-Cruet MJ (2006) Endoscopic posterior cervical foraminotomy and discectomy. Neurosurg Clin N Am 17:411–422CrossRefPubMed
32.
go back to reference Hilton DL Jr (2007) Minimally invasive tubular access for posterior cervical foraminotomy with three-dimensional microscopic visualization and localization with anterior/posterior imaging. Spine J 7:154–158CrossRefPubMed Hilton DL Jr (2007) Minimally invasive tubular access for posterior cervical foraminotomy with three-dimensional microscopic visualization and localization with anterior/posterior imaging. Spine J 7:154–158CrossRefPubMed
34.
go back to reference Ruetten S, Komp M, Godolias G (2005) An extreme lateral access for the surgery of lumbar disc herniations inside the spinal canal using the full-endoscopic uniportal transforaminal approach-technique and prospective results of 463 patients. Spine (Phila Pa 1976) 30:2570–2578CrossRef Ruetten S, Komp M, Godolias G (2005) An extreme lateral access for the surgery of lumbar disc herniations inside the spinal canal using the full-endoscopic uniportal transforaminal approach-technique and prospective results of 463 patients. Spine (Phila Pa 1976) 30:2570–2578CrossRef
35.
go back to reference Birkenmaier C, Komp M, Leu HF, Wegener B, Ruetten S (2013) The current state of endoscopic disc surgery: review of controlled studies comparing full-endoscopic procedures for disc herniations to standard procedures. Pain Physician 16:335–344PubMed Birkenmaier C, Komp M, Leu HF, Wegener B, Ruetten S (2013) The current state of endoscopic disc surgery: review of controlled studies comparing full-endoscopic procedures for disc herniations to standard procedures. Pain Physician 16:335–344PubMed
38.
go back to reference Ahn Y, Lee SH, Park WM, Lee HY, Shin SW, Kang HY (2004) Percutaneous endoscopic lumbar discectomy for recurrent disc herniation: surgical technique, outcome, and prognostic factors of 43 consecutive cases. Spine (Phila Pa 1976) 29:E326CrossRef Ahn Y, Lee SH, Park WM, Lee HY, Shin SW, Kang HY (2004) Percutaneous endoscopic lumbar discectomy for recurrent disc herniation: surgical technique, outcome, and prognostic factors of 43 consecutive cases. Spine (Phila Pa 1976) 29:E326CrossRef
40.
go back to reference Zdeblick TA, Zou D, Warden KE, McCabe R, Kunz D, Vanderby R (1992) Cervical stability after foraminotomy. A biomechanical in vitro analysis. J Bone Joint Surg Am 74:22–27CrossRefPubMed Zdeblick TA, Zou D, Warden KE, McCabe R, Kunz D, Vanderby R (1992) Cervical stability after foraminotomy. A biomechanical in vitro analysis. J Bone Joint Surg Am 74:22–27CrossRefPubMed
41.
go back to reference Mayer HM, Brock M (1993) Percutaneous endoscopic discectomy: surgical technique and preliminary results compared to microsurgical discectomy. J Neurosurg 78:216–225CrossRefPubMed Mayer HM, Brock M (1993) Percutaneous endoscopic discectomy: surgical technique and preliminary results compared to microsurgical discectomy. J Neurosurg 78:216–225CrossRefPubMed
42.
go back to reference Hermantin FU, Peters T, Quartararo L, Kambin P (1999) A prospective, randomized study comparing the results of open discectomy with those of video-assisted arthroscopic microdiscectomy. J Bone Joint Surg Am 81:958–965CrossRefPubMed Hermantin FU, Peters T, Quartararo L, Kambin P (1999) A prospective, randomized study comparing the results of open discectomy with those of video-assisted arthroscopic microdiscectomy. J Bone Joint Surg Am 81:958–965CrossRefPubMed
43.
go back to reference Hoogland T, Schubert M, Miklitz B, Ramirez A (2006) Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine 31:E890–E897CrossRefPubMed Hoogland T, Schubert M, Miklitz B, Ramirez A (2006) Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine 31:E890–E897CrossRefPubMed
47.
go back to reference Li XC, Zhong CF, Deng GB, Liang RW, Huang CM (2016) Full-endoscopic procedures versus traditional discectomy surgery for discectomy: a systematic review and meta-analysis of current global clinical trials. Pain Physician 19:103–118CrossRefPubMed Li XC, Zhong CF, Deng GB, Liang RW, Huang CM (2016) Full-endoscopic procedures versus traditional discectomy surgery for discectomy: a systematic review and meta-analysis of current global clinical trials. Pain Physician 19:103–118CrossRefPubMed
60.
Metadata
Title
Endoscopic spine discectomy: indications and outcomes
Author
Yong Ahn
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 4/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-04283-w

Other articles of this Issue 4/2019

International Orthopaedics 4/2019 Go to the issue