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Novel Instruments for Percutaneous Biportal Endoscopic Spine Surgery for Full Decompression and Dural Management: A Comparative Analysis

Background: Post-laminectomy syndrome is a common cause of dissatisfaction after endoscopic interlaminar approach. Our aim was to evaluate the efficacy and safety of our two newly designed instruments for laminotomy, a dural protector attached to the scope and a knot pusher for water-tight suturing...

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Autores principales: Hong, Young-Ho, Kim, Seung-Kook, Suh, Dong-Won, Lee, Su-Chan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463780/
https://www.ncbi.nlm.nih.gov/pubmed/32759697
http://dx.doi.org/10.3390/brainsci10080516
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author Hong, Young-Ho
Kim, Seung-Kook
Suh, Dong-Won
Lee, Su-Chan
author_facet Hong, Young-Ho
Kim, Seung-Kook
Suh, Dong-Won
Lee, Su-Chan
author_sort Hong, Young-Ho
collection PubMed
description Background: Post-laminectomy syndrome is a common cause of dissatisfaction after endoscopic interlaminar approach. Our aim was to evaluate the efficacy and safety of our two newly designed instruments for laminotomy, a dural protector attached to the scope and a knot pusher for water-tight suturing of the incidental dural tears. Material and Methods: This was a multicenter evaluation. Efficacy was quantified as the pre-to-postoperative improvement in pain (visual analog scale), disability (Oswestry Disability Index), patient satisfaction (modified MacNab score), and length of hospital stay. Safety was quantified by the incidence and location of dural tears, rate of revision, and radiological outcomes. Outcomes were evaluated between the control (before instrument development) and experimental (after instrument development) groups. Results: There was a significant improvement in leg pain in the experimental group (p = 0.03), with greater patient satisfaction in the control group (p < 0.01). There was no incidence of dural tears in the area of the traversing and exiting nerve roots in the experimental group. Water-tightness of sutures was confirmed radiologically. Conclusion: The novel dural protector and the knot pusher for water-tight sutures improved the efficacy and safety of decompression and discectomy; however, a prolonged operative time was a drawback.
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spelling pubmed-74637802020-09-02 Novel Instruments for Percutaneous Biportal Endoscopic Spine Surgery for Full Decompression and Dural Management: A Comparative Analysis Hong, Young-Ho Kim, Seung-Kook Suh, Dong-Won Lee, Su-Chan Brain Sci Article Background: Post-laminectomy syndrome is a common cause of dissatisfaction after endoscopic interlaminar approach. Our aim was to evaluate the efficacy and safety of our two newly designed instruments for laminotomy, a dural protector attached to the scope and a knot pusher for water-tight suturing of the incidental dural tears. Material and Methods: This was a multicenter evaluation. Efficacy was quantified as the pre-to-postoperative improvement in pain (visual analog scale), disability (Oswestry Disability Index), patient satisfaction (modified MacNab score), and length of hospital stay. Safety was quantified by the incidence and location of dural tears, rate of revision, and radiological outcomes. Outcomes were evaluated between the control (before instrument development) and experimental (after instrument development) groups. Results: There was a significant improvement in leg pain in the experimental group (p = 0.03), with greater patient satisfaction in the control group (p < 0.01). There was no incidence of dural tears in the area of the traversing and exiting nerve roots in the experimental group. Water-tightness of sutures was confirmed radiologically. Conclusion: The novel dural protector and the knot pusher for water-tight sutures improved the efficacy and safety of decompression and discectomy; however, a prolonged operative time was a drawback. MDPI 2020-08-04 /pmc/articles/PMC7463780/ /pubmed/32759697 http://dx.doi.org/10.3390/brainsci10080516 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hong, Young-Ho
Kim, Seung-Kook
Suh, Dong-Won
Lee, Su-Chan
Novel Instruments for Percutaneous Biportal Endoscopic Spine Surgery for Full Decompression and Dural Management: A Comparative Analysis
title Novel Instruments for Percutaneous Biportal Endoscopic Spine Surgery for Full Decompression and Dural Management: A Comparative Analysis
title_full Novel Instruments for Percutaneous Biportal Endoscopic Spine Surgery for Full Decompression and Dural Management: A Comparative Analysis
title_fullStr Novel Instruments for Percutaneous Biportal Endoscopic Spine Surgery for Full Decompression and Dural Management: A Comparative Analysis
title_full_unstemmed Novel Instruments for Percutaneous Biportal Endoscopic Spine Surgery for Full Decompression and Dural Management: A Comparative Analysis
title_short Novel Instruments for Percutaneous Biportal Endoscopic Spine Surgery for Full Decompression and Dural Management: A Comparative Analysis
title_sort novel instruments for percutaneous biportal endoscopic spine surgery for full decompression and dural management: a comparative analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463780/
https://www.ncbi.nlm.nih.gov/pubmed/32759697
http://dx.doi.org/10.3390/brainsci10080516
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