Christoph P Hofstetter1, Yong Ahn2, Gun Choi3, J N A Gibson4, S Ruetten5, Yue Zhou6, Zhen Zhou Li7, Christoph J Siepe8, Ralf Wagner9, Jun-Ho Lee10, Koichi Sairyo11, Kyung Chul Choi12, Chien-Min Chen13, A E Telfeian14, Xifeng Zhang15, Arun Banhot16, Pramod V Lokhande17, N Prada18, Jian Shen19, F C Cortinas20, N P Brooks21, Peter Van Daele22, Vit Kotheeranurak23, Saqib Hasan24, Gun Keorochana24, Mohammed Assous25, Roger Härtl26, Jin-Sung Kim27. 1. University of Washington, Seattle, WA, USA. 2. Gachon University, Incheon, South Korea. 3. Wooridul Spine Hospital, Pohang, South Korea. 4. Spire Murrayfield Hospital, Edinburgh, UK. 5. Center for Spine Surgery and Pain Therapy, Center for Orthopedics and Traumatology of the St. Elisabeth Group-Catholic Hospital Rhein-Ruhr, St. Anna Hospital Herne/Marien Hospital Herne University Hospital of the Ruhr University of Bochum/Marien Hospital Witten, Herne, Germany. 6. Xinquiao Hospital, Third Military Medical University, Chongquing, China. 7. Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, China. 8. Schön Clinic Munich Harlaching, Munich, Germany. 9. Ligamenta Spine Center, Frankfurt am Main, Germany. 10. Kyung Hee University Medical Centre, Seoul, South Korea. 11. The University of Tokushima, Tokushima, Japan. 12. The Leon Wiltse Memorial Hospital, Anyang, South Korea. 13. Changhua Christian Hospital, Changhua, and Dayeh University, Changhua. 14. Rhode Island Hospital, The Warren Alpert Medical School of Brown, Providence, RI, USA. 15. The General Hospital of Chinese People's Liberation Army, Beijing, China. 16. Columbia Asia Hospital, Gurugram, Haryana, India. 17. SKN Medical College, Pune, India. 18. Foscal International Clinic, Floridablanca, Colombia. 19. Mohawk Valley Orthopedics, Amsterdam, NY, USA. 20. Hospital Angeles Pedregal Camino Santa Teresa, Mexico City, Mexico. 21. University of Wisconsin, Maddison, WI, USA. 22. O.L.V. van Lourdes Ziekenhuis, Waregem, Belgium. 23. Queen Savang Vadhana Memorial Hospital, Sriracha, Chonburi, Thailand. 24. Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 25. Razi Spine Clinic-Minimally Invasive Spine Surgery, Amman, Jordan. 26. Weill Cornell Medical College, New York, NY, USA. 27. St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Abstract
STUDY DESIGN: International consensus paper on a unified nomenclature for full-endoscopic spine surgery. OBJECTIVES: Minimally invasive endoscopic spinal procedures have undergone rapid development during the past decade. Evolution of working-channel endoscopes and surgical instruments as well as innovation in surgical techniques have expanded the types of spinal pathology that can be addressed. However, there is in the literature a heterogeneous nomenclature defining approach corridors and procedures, and this lack of common language has hampered communication between endoscopic spine surgeons, patients, hospitals, and insurance providers. METHODS: The current report summarizes the nomenclature reported for working-channel endoscopic procedures that address cervical, thoracic, and lumbar spinal pathology. RESULTS: We propose a uniform system that defines the working-channel endoscope (full-endoscopic), approach corridor (anterior, posterior, interlaminar, transforaminal), spinal segment (cervical, thoracic, lumbar), and procedure performed (eg, discectomy, foraminotomy). We suggest the following nomenclature for the most common full-endoscopic procedures: posterior endoscopic cervical foraminotomy (PECF), transforaminal endoscopic thoracic discectomy (TETD), transforaminal endoscopic lumbar discectomy (TELD), transforaminal lumbar foraminotomy (TELF), interlaminar endoscopic lumbar discectomy (IELD), interlaminar endoscopic lateral recess decompression (IE-LRD), and lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD). CONCLUSIONS: We believe that it is critical to delineate a consensus nomenclature to facilitate uniformity of working-channel endoscopic procedures within academic scholarship. This will hopefully facilitate development, standardization of procedures, teaching, and widespread acceptance of full-endoscopic spinal procedures.
STUDY DESIGN: International consensus paper on a unified nomenclature for full-endoscopic spine surgery. OBJECTIVES: Minimally invasive endoscopic spinal procedures have undergone rapid development during the past decade. Evolution of working-channel endoscopes and surgical instruments as well as innovation in surgical techniques have expanded the types of spinal pathology that can be addressed. However, there is in the literature a heterogeneous nomenclature defining approach corridors and procedures, and this lack of common language has hampered communication between endoscopic spine surgeons, patients, hospitals, and insurance providers. METHODS: The current report summarizes the nomenclature reported for working-channel endoscopic procedures that address cervical, thoracic, and lumbar spinal pathology. RESULTS: We propose a uniform system that defines the working-channel endoscope (full-endoscopic), approach corridor (anterior, posterior, interlaminar, transforaminal), spinal segment (cervical, thoracic, lumbar), and procedure performed (eg, discectomy, foraminotomy). We suggest the following nomenclature for the most common full-endoscopic procedures: posterior endoscopic cervical foraminotomy (PECF), transforaminal endoscopic thoracic discectomy (TETD), transforaminal endoscopic lumbar discectomy (TELD), transforaminal lumbar foraminotomy (TELF), interlaminar endoscopic lumbar discectomy (IELD), interlaminar endoscopic lateral recess decompression (IE-LRD), and lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD). CONCLUSIONS: We believe that it is critical to delineate a consensus nomenclature to facilitate uniformity of working-channel endoscopic procedures within academic scholarship. This will hopefully facilitate development, standardization of procedures, teaching, and widespread acceptance of full-endoscopic spinal procedures.
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