Working Cannula-Based Endoscopic Foraminoplasty: A Technical Note

Purpose. Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive disc surgery that can be performed under local anesthesia and requires only an eight-mm skin incision. For the patients with lumbar foraminal stenosis, the migrated disc is difficult to remove with a simple transforami...

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Main Authors: Suxi Gu, Kedong Hou, Wei Jian, Jianwei Du, Songhua Xiao, Xifeng Zhang
Format: Article
Language:English
Published: Hindawi Limited 2018-01-01
Series:BioMed Research International
Online Access:http://dx.doi.org/10.1155/2018/4749560
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spelling doaj-c8c9ff2ec4ce424ab256418e570b7b582020-11-25T00:03:38ZengHindawi LimitedBioMed Research International2314-61332314-61412018-01-01201810.1155/2018/47495604749560Working Cannula-Based Endoscopic Foraminoplasty: A Technical NoteSuxi Gu0Kedong Hou1Wei Jian2Jianwei Du3Songhua Xiao4Xifeng Zhang5Orthopedic Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102248, ChinaOrthopedic Department, Beijing Friendship Hospital Pinggu Campus, Capital Medical University, Beijing 101200, ChinaOrthopedic Department, Beijing PLA 309 Hospital, Beijing 100091, ChinaOrthopedic Department, Yangzhou No. 1 People’s Hospital, Yangzhou, Jiangsu Province 225001, ChinaOrthopedic Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102248, ChinaOrthopedic Department, PLA General Hospital, Beijing 100853, ChinaPurpose. Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive disc surgery that can be performed under local anesthesia and requires only an eight-mm skin incision. For the patients with lumbar foraminal stenosis, the migrated disc is difficult to remove with a simple transforaminal approach. In such cases, the foraminoplasty techniques can be used. However, obtaining efficient foramen enlargement while minimizing radiation exposure and protecting the nerves can be challenging. Methods. In this study, we propose a new technique called the Kiss-Hug maneuver. Under endoscopic viewing, we used the bevel tip of a working cannula as a bone reamer to enlarge the foramen. This allowed us to efficiently enlarge the lumbar foramen endoscopically without the redundancy and complications associated with reamers or trephines. Results. Details of the four steps of the Kiss-Hug maneuver are reported along with adverse events. The advantages of this new technique include minimizing radiation exposure to both the surgeon and the patient and decreasing the overall operation time. Conclusion. The endoscopic Kiss-Hug maneuver is a useful and reliable foraminoplasty technique that can enhance the efficiency of foraminoplasty while ensuring patient safety and reducing radiation exposure.http://dx.doi.org/10.1155/2018/4749560
collection DOAJ
language English
format Article
sources DOAJ
author Suxi Gu
Kedong Hou
Wei Jian
Jianwei Du
Songhua Xiao
Xifeng Zhang
spellingShingle Suxi Gu
Kedong Hou
Wei Jian
Jianwei Du
Songhua Xiao
Xifeng Zhang
Working Cannula-Based Endoscopic Foraminoplasty: A Technical Note
BioMed Research International
author_facet Suxi Gu
Kedong Hou
Wei Jian
Jianwei Du
Songhua Xiao
Xifeng Zhang
author_sort Suxi Gu
title Working Cannula-Based Endoscopic Foraminoplasty: A Technical Note
title_short Working Cannula-Based Endoscopic Foraminoplasty: A Technical Note
title_full Working Cannula-Based Endoscopic Foraminoplasty: A Technical Note
title_fullStr Working Cannula-Based Endoscopic Foraminoplasty: A Technical Note
title_full_unstemmed Working Cannula-Based Endoscopic Foraminoplasty: A Technical Note
title_sort working cannula-based endoscopic foraminoplasty: a technical note
publisher Hindawi Limited
series BioMed Research International
issn 2314-6133
2314-6141
publishDate 2018-01-01
description Purpose. Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive disc surgery that can be performed under local anesthesia and requires only an eight-mm skin incision. For the patients with lumbar foraminal stenosis, the migrated disc is difficult to remove with a simple transforaminal approach. In such cases, the foraminoplasty techniques can be used. However, obtaining efficient foramen enlargement while minimizing radiation exposure and protecting the nerves can be challenging. Methods. In this study, we propose a new technique called the Kiss-Hug maneuver. Under endoscopic viewing, we used the bevel tip of a working cannula as a bone reamer to enlarge the foramen. This allowed us to efficiently enlarge the lumbar foramen endoscopically without the redundancy and complications associated with reamers or trephines. Results. Details of the four steps of the Kiss-Hug maneuver are reported along with adverse events. The advantages of this new technique include minimizing radiation exposure to both the surgeon and the patient and decreasing the overall operation time. Conclusion. The endoscopic Kiss-Hug maneuver is a useful and reliable foraminoplasty technique that can enhance the efficiency of foraminoplasty while ensuring patient safety and reducing radiation exposure.
url http://dx.doi.org/10.1155/2018/4749560
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