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Medicina
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Recent Advances in Endoscopic Spine Surgery
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Recent Advances in Endoscopic Spine Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (21 April 2023) | Viewed by 13472

Special Issue Editors

Dr. Pang Hung Wu

E-Mail Website
Guest Editor
Senior Consultant, Achieve Spine and Orthopaedic Centre, Mount Elizabeth Hospital and Mount Elizabeth Novena Hospital, Singapore
Interests: minimally invasive spine surgery; endoscopic spine surgery; spine surgery; orthopaedic surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Hyeun Sung Kim

E-Mail Website
Guest Editor
President, Harrison Spinartus Hospital, Seoul, Republic of Korea
Interests: minimally invasive spine surgery; endoscopic spine surgery; spine surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Javier Quillo-Olvera

E-Mail Website
Guest Editor
Spine Center, Hospital H+ Querétaro, School of Medicine, Universidad Anáhuac Querétaro, Querétaro, Mexico
Interests: biportal endoscopic spine surgery

Special Issue Information

Dear Colleagues, 

Patient demands are increasing in the modern era, with patients no long being fully satisfied with adequate spinal decompression and the removal of spinal pathology; patients now seek minimal soft-tissue damage, an early return to work and the preservation of spinal stability. The early development of uniportal endoscopic spine surgery and the subsequent recent development of biportal endoscopic spine surgery has evolved into the treatment of many degenerative spinal conditions. Such methods are gaining traction among spine surgeons, as they tick many boxes with regard to the concept of minimally invasive spine surgery.

This Special Issue, entitled “Recent Advances in Endoscopic Spine Surgery”, aims to publish the latest research focused on uniportal, biportal, and other forms of endoscopic spine surgery.

We invite cutting-edge papers related to spinal endoscopy, including basic science, clinical studies, systematic reviews, and meta-analyses. Valuable editorials and expert review articles will also be considered.

Dr. Pang Hung Wu
Dr. Hyeun Sung Kim
Dr. Javier Quillo-Olvera
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • degenerative spine
  • endoscopic spine surgery
  • minimally invasive spine surgery
  • unilateral biportal endoscopy

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Published Papers (5 papers)

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10 pages, 2170 KiB  
Article
Clinical and Radiological Outcomes of a Comparative Study of Anterior Cervical Decompression and Fusion with Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) for Cervical Foraminal Pathology
by Hyeun Sung Kim, Pang Hung Wu, Brian Zhao Jie Chin and Il Tae Jang
Medicina 2023, 59(7), 1222; https://doi.org/10.3390/medicina59071222 - 29 Jun 2023
Viewed by 1495
Abstract
Background and Objectives: The purpose was to compaSre medium-term clinical and radiological outcomes of Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) surgery versus Anterior Cervical Discectomy and Fusion (ACDF) for patients with cervical disc herniations and foraminal pathologies. Materials [...] Read more.
Background and Objectives: The purpose was to compaSre medium-term clinical and radiological outcomes of Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) surgery versus Anterior Cervical Discectomy and Fusion (ACDF) for patients with cervical disc herniations and foraminal pathologies. Materials and Methods: A prospective registry of patients who had undergone either PPPV PECD surgery or ACDF surgery for cervical disc herniation or foraminal pathologies under a single fellowship-trained spine surgeon was performed. The baseline characteristics and operative details including complications were recorded for all included patients. The clinical outcomes evaluated include VAS, MJOA, motor score, and NDI and MacNab’s score. The radiological parameters in neutral-measured facet length, facet area, disc height, C2–C7 angle, neck tilt angle, T1 slope and thoracic inlet angle were also evaluated. Results: A total of 55 patients (29 PPPV PECD, 26 ACDF) were included, with mean follow-up periods of 21.9 and 32.3 months, respectively. Each cohort was noted to have a single case of surgical complication. Statistically significant changes of facet area (49.05 ± 14.50%) and facet length (52.71 ± 15.11%) were noted in the PPPV PECD group. At neutral alignment of the neck on a lateral X-ray, compared to ACDF, PPPV PECD had a statistically significant change in neck tilt angle (−11.68 ± 17.35°) and T1 slope angle (−11.69 ± 19.58°). Whilst both PPPV PECD and ACDF had significant improvements in VAS, MJOA and NDI postoperatively, PPPV PECD was found to be superior across all above scores at various follow-up timepoints compared to its ACDF counterparts. Conclusions: PPPV PECD surgery achieved a satisfactory radiological correction of neck alignment and significantly improved clinical outcomes at medium-term follow-up for our cohort of patients, highlighting its feasibility in treating patients with cervical disc herniations and foraminal pathologies. Full article
(This article belongs to the Special Issue Recent Advances in Endoscopic Spine Surgery)
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11 pages, 678 KiB  
Systematic Review
An Effectiveness Evaluation of Nucleo-Annuloplasty for Lumbar Discogenic Lesions Using Disc-FX: A Scoping Review
by Guang-Xun Lin, Shang-Wun Jhang and Chien-Min Chen
Medicina 2023, 59(7), 1291; https://doi.org/10.3390/medicina59071291 - 13 Jul 2023
Cited by 1 | Viewed by 1923
Abstract
Background and Objectives: Degenerative disk disease is a widespread chronic condition that causes diskogenic pain. Diskogenic pain can be treated with various therapy methods. Disc-FX is a revolutionary, minimally invasive, percutaneous nucleo-annuloplasty method that combines manual diskectomy with nuclear and annular remodeling [...] Read more.
Background and Objectives: Degenerative disk disease is a widespread chronic condition that causes diskogenic pain. Diskogenic pain can be treated with various therapy methods. Disc-FX is a revolutionary, minimally invasive, percutaneous nucleo-annuloplasty method that combines manual diskectomy with nuclear and annular remodeling using radiofrequency ablation to relieve diskogenic pain. In this study, the technical features, clinical outcomes, and complications of Disc-FX are summarized. Materials and Methods: A comprehensive literature review was performed. By exploring several databases, we collected studies on Disc-FX for treating diskogenic pain. The outcomes included perioperative data, clinical results, and complications. Results: In the 15 studies included, data from 570 patients were collected. L4–L5 was the most frequently operated level, and most cases underwent single-level procedures. The follow-up period for these patients ranged from 2 months to 24 months. One study reported a procedure time between 35 and 60 min, whereas the remaining studies reported a procedure time of less than 30 min. The mean visual analog scale score decreased from 7.22 preoperatively to 1.81 at the final follow-up. The mean numerical rating scale score decreased from 6.98 preoperatively to 3.9 at the final follow-up. The mean Japanese Orthopaedic Association score improved from 16.26 preoperatively to 25.88 in the final follow-up. The mean Oswestry Disability Index score decreased from 35.37 preoperatively to 14.66 at the final follow-up. The mean satisfaction rate (based on the Macnab criteria) was 87.6% (range, 78.4–95.2%). The total incidence of postoperative transient pain was 8.77% (50/570) after nucleo-annuloplasty using Disc-FX, and recurrence was 1.58% (9/570). Conclusions: According to our comprehensive evaluation, using percutaneous nucleo-annuloplasty for treating lumbar diskogenic diseases provided considerable pain alleviation and improved functional outcomes with fewer complications. Disc-FX is a safe and effective procedure that is a good treatment option for patients with diskogenic pain. Full article
(This article belongs to the Special Issue Recent Advances in Endoscopic Spine Surgery)
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14 pages, 3560 KiB  
Case Report
Fully Endoscopic Spine Separation Surgery in Metastatic Disease—Case Series, Technical Notes, and Preliminary Findings
by Kajetan Latka, Waldemar Kolodziej, Kornel Pawlak, Tomasz Sobolewski, Rafal Rajski, Jacek Chowaniec, Tomasz Olbrycht, Masato Tanaka and Dariusz Latka
Medicina 2023, 59(5), 993; https://doi.org/10.3390/medicina59050993 - 21 May 2023
Cited by 9 | Viewed by 2865
Abstract
Objective: This report aims to describe the surgical methodology and potential effectiveness of endoscopic separation surgery (ESS) in patients with metastatic spine disease. This concept may reduce the invasiveness of the procedure, which can potentially speed up the wound healing process and, [...] Read more.
Objective: This report aims to describe the surgical methodology and potential effectiveness of endoscopic separation surgery (ESS) in patients with metastatic spine disease. This concept may reduce the invasiveness of the procedure, which can potentially speed up the wound healing process and, thus, the possibility of faster application of radiotherapy. Materials and Methods: In this study, separation surgery for preparing patients for stereotactic body radiotherapy (SBRT) was performed with fully endoscopic spine surgery (FESS) followed by percutaneous screw fixation (PSF). Results: Three patients with metastatic spine disease in the thoracic spine were treated with fully endoscopic spine separation surgery. The first case resulted in the progression of paresis symptoms that resulted in disqualification from further oncological treatment. The remaining two patients achieved satisfactory clinical and radiological effects and were referred for additional radiotherapy. Conclusions: With advancements in medical technology, such as endoscopic visualization, and new tools for coagulation, we can treat more and more spine diseases. Until now, spine metastasis was not an indication for the use of endoscopy. This method is very technically challenging and risky, especially at such an early stage of application, due to variations in the patient’s condition, morphological diversity, and the nature of metastatic lesions in the spine. Further trials are needed to determine whether this new approach to treating patients with spine metastases is a promising breakthrough or a dead end. Full article
(This article belongs to the Special Issue Recent Advances in Endoscopic Spine Surgery)
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13 pages, 4061 KiB  
Technical Note
Comparison of Outcomes between Unilateral Biportal Endoscopic and Percutaneous Posterior Endoscopic Cervical Keyhole Surgeries
by Dong Wang, Jinchao Xu, Chengyue Zhu, Wei Zhang and Hao Pan
Medicina 2023, 59(3), 437; https://doi.org/10.3390/medicina59030437 - 23 Feb 2023
Cited by 11 | Viewed by 3346
Abstract
Objective: The purpose of this study was to compare the clinical and radiological outcomes of unilateral biportal endoscopic (UBE) and percutaneous posterior endoscopic cervical discectomy (PE) keyhole surgeries. Methods: Patients diagnosed with cervical spondylotic radiculopathy (CSR) treated by UBE or PE [...] Read more.
Objective: The purpose of this study was to compare the clinical and radiological outcomes of unilateral biportal endoscopic (UBE) and percutaneous posterior endoscopic cervical discectomy (PE) keyhole surgeries. Methods: Patients diagnosed with cervical spondylotic radiculopathy (CSR) treated by UBE or PE keyhole surgery from May 2017 to April 2020 were retrospectively analyzed. The length of incision, fluoroscopic time, postoperative hospital stay, and total cost were compared. The clinical efficacy was assessed using a visual analog scale (VAS), neck disability index (NDI), and modified MacNab criteria. Moreover, the C2-7 Cobb’s angle, range of motion (ROM), intervertebral height, vertebral horizontal displacement, and angular displacement of the surgical segment were measured. Results: A total of 154 patients were enrolled, including 89 patients in the UBE group and 65 patients in the PE group, with a follow-up period of 24–32 months. Compared with PE surgery, UBE surgery required shorter fluoroscopic times (6.76 ± 1.09 vs. 8.31 ± 1.10 s) and operation times (77.48 ± 17.37 vs. 84.92 ± 21.97 min) but led to higher total hospitalization costs and longer incisions. No significant differences were observed in the postoperative hospital stay, bleeding volume, VAS score, NDI score, effective rate, or complication rate between the UBE and PE groups. Both the C2-7 Cobb’s angle and ROM increased significantly after surgery, with no significant differences between groups. There were no significant differences between intervertebral height, vertebral horizontal displacement, and angular displacement of the surgical segment at different times. Conclusions: Both UBE and PE surgeries in the treatment of CSR were effective and similar after 24 months. The fluoroscopic and operation times of UBE were shorter than those of PE. Full article
(This article belongs to the Special Issue Recent Advances in Endoscopic Spine Surgery)
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8 pages, 44756 KiB  
Technical Note
Unilateral Biportal Endoscopic Laminectomy for Treating Cervical Stenosis: A Technical Note and Preliminary Results
by Chengyue Zhu, Xizhuo Zhou, Guofen Ge, Cuijuan Wang, Xiaoshan Zhuang, Wei Cheng, Dong Wang, Hang Zhu, Hao Pan and Wei Zhang
Medicina 2023, 59(2), 305; https://doi.org/10.3390/medicina59020305 - 7 Feb 2023
Cited by 8 | Viewed by 2355
Abstract
Objective: The objective of this study was to introduce a surgical technique for the percutaneous decompression of cervical stenosis (CS) using a unilateral biportal endoscopic approach and characterize its early clinical and radiographic results. Materials and Methods: Nineteen consecutive patients with [...] Read more.
Objective: The objective of this study was to introduce a surgical technique for the percutaneous decompression of cervical stenosis (CS) using a unilateral biportal endoscopic approach and characterize its early clinical and radiographic results. Materials and Methods: Nineteen consecutive patients with CS who needed surgical intervention were recruited. All enrolled patients underwent unilateral biportal endoscopic laminectomy (UBEL). All patients were followed postoperatively for >1 year. The preoperative and final follow-up evaluations included the Japanese Orthopedic Association (JOA) score for neurological assessment, visual analogue scale (VAS) for axial pain and C2–C7 Cobb angle for cervical sagittal alignment. The postoperative complications were analyzed. Results: Thirteen males and six females were included in the analysis. The mean follow-up period was 16.3 ± 2.6 months. The mean operative time was 82.6 ± 18.4 min. Postoperative MRI and CT revealed ideal neural decompression of the treated segments in all patients. Preoperative VAS and JOA scores improved significantly after the surgery, and cervical lordosis was preserved on the postoperative images. Conclusions: UBEL was an effective surgical method for CS, which may also minimize iatrogenic damage to the posterior tension band (PTB) and help to maximize the preservation of the cervical lordosis. Full article
(This article belongs to the Special Issue Recent Advances in Endoscopic Spine Surgery)
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