Guntram Krzok1, Albert E Telfeian2, Ralf Wagner3, Menno Iprenburg4. 1. SRH Hospital Waltershausen-Friedrichroda, Friedrichroda, Germany. 2. Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA. 3. Ligamenta Spine Centre, Frankfurt am Main, Germany. 4. Spine Clinic Iprenburg, Veenhuizen, The Netherlands.
Abstract
BACKGROUND: Lumbar facet cysts are a benign, degenerative, and fairly uncommon cause for lumbar radiculopathy. The standard surgical treatment for lumbar facet cysts often requires a laminectomy and medial facetectomy which can further destabilize a pathological motion segment. The authors present here a novel technique for transpedicular endoscopic access to the pathology that obviates the need to violate the lamina or facet. METHODS: Two patient cases are described where the lumbar 4-5 facet cysts arise medial to the pedicle. Percutaneous access to the cysts was established by drilling through the adjacent pedicle creating a 7-mm corridor to establish access for the endoscopic tubular retractor and the working channel endoscope. Straight and bendable forceps were used to remove the cysts under direct visualization. RESULTS: Following surgery, the patients' symptoms showed immediate regression with complete relief of one patient's foot drop by 6 months. CONCLUSIONS: Transpedicular endoscopic access is described as novel minimally invasive surgical option in the awake patient for lumbar facet cysts adjacent to the Lumbar 4 or 5 pedicle.
BACKGROUND: Lumbar facet cysts are a benign, degenerative, and fairly uncommon cause for lumbar radiculopathy. The standard surgical treatment for lumbar facet cysts often requires a laminectomy and medial facetectomy which can further destabilize a pathological motion segment. The authors present here a novel technique for transpedicular endoscopic access to the pathology that obviates the need to violate the lamina or facet. METHODS: Two patient cases are described where the lumbar 4-5 facet cysts arise medial to the pedicle. Percutaneous access to the cysts was established by drilling through the adjacent pedicle creating a 7-mm corridor to establish access for the endoscopic tubular retractor and the working channel endoscope. Straight and bendable forceps were used to remove the cysts under direct visualization. RESULTS: Following surgery, the patients' symptoms showed immediate regression with complete relief of one patient's foot drop by 6 months. CONCLUSIONS: Transpedicular endoscopic access is described as novel minimally invasive surgical option in the awake patient for lumbar facet cysts adjacent to the Lumbar 4 or 5 pedicle.
Authors: Martin Komp; Patrick Hahn; Semih Ozdemir; Harry Merk; Richard Kasch; Georgios Godolias; Sebastian Ruetten Journal: Surg Innov Date: 2014-03-25 Impact factor: 2.058
Authors: Christoph P Hofstetter; Yong Ahn; Gun Choi; J N A Gibson; S Ruetten; Yue Zhou; Zhen Zhou Li; Christoph J Siepe; Ralf Wagner; Jun-Ho Lee; Koichi Sairyo; Kyung Chul Choi; Chien-Min Chen; A E Telfeian; Xifeng Zhang; Arun Banhot; Pramod V Lokhande; N Prada; Jian Shen; F C Cortinas; N P Brooks; Peter Van Daele; Vit Kotheeranurak; Saqib Hasan; Gun Keorochana; Mohammed Assous; Roger Härtl; Jin-Sung Kim Journal: Global Spine J Date: 2020-05-28