Skip to main content

Main menu

  • Home
  • Content
    • Current Issue
    • Advance Online Publication
    • Archive
  • About Us
    • About ISASS
    • About the Journal
    • Author Instructions
    • Editorial Board
    • Reviewer Guidelines & Publication Criteria
  • More
    • Advertise
    • Subscribe
    • Alerts
    • Feedback
  • Join Us
  • Reprints & Permissions
  • Sponsored Content
  • Other Publications
    • ijss

User menu

  • My alerts
  • Log out

Search

  • Advanced search
International Journal of Spine Surgery
  • My alerts
  • Log out
International Journal of Spine Surgery

Advanced Search

  • Home
  • Content
    • Current Issue
    • Advance Online Publication
    • Archive
  • About Us
    • About ISASS
    • About the Journal
    • Author Instructions
    • Editorial Board
    • Reviewer Guidelines & Publication Criteria
  • More
    • Advertise
    • Subscribe
    • Alerts
    • Feedback
  • Join Us
  • Reprints & Permissions
  • Sponsored Content
  • Follow ijss on Twitter
  • Visit ijss on Facebook
Research ArticleMinimally Invasive Surgery

Use of “Inside-Out” Technique for Direct Visualization of a Vacuum Vertically Unstable Intervertebral Disc During Routine Lumbar Endoscopic Transforaminal Decompression—A Correlative Study of Clinical Outcomes and the Prognostic Value of Lumbar Radiographs

KAI-UWE LEWANDROWSKI, JORGE FELIPE RAMÍREZ LEÓN and ANTHONY YEUNG
International Journal of Spine Surgery October 2019, 13 (5) 399-414; DOI: https://doi.org/10.14444/6055
KAI-UWE LEWANDROWSKI
1Center for Advanced Spine Care of Southern Arizona, Tucson, Arizona
2Surgical Institute of Tucson, Tucson, Arizona
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
JORGE FELIPE RAMÍREZ LEÓN
3Spine Surgery Program, Universidad El Bosque, Bogotá, Colombia
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
ANTHONY YEUNG
4Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, New Mexico
5Desert Institute for Spine Care, Phoenix, Arizona
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Figure 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1

    Age distribution of surgical patients who underwent endoscopic transforaminal foraminoplasty and discectomy.

  • Figure 2
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 2

    Plot of length of follow-up against age showing follow-up in most of the older patients with intraoperatively visualized vacuum disc to be much longer than 24 months.

  • Figure 3
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 3

    Intraoperative fluoroscopic and associated endoscopic images taken during transforaminal microdiscectomy and foraminoplasty with initial intradiscal probing of the surgical intervertebral disc after foraminoplasty using the “inside-out” technique to test for the presence of a vacuum disc. Vacuum disc with the pituitary rongeur advanced to the opposite annulus at the L4/L5 and L5/S1 level: (a) endoscopic view showing cavitation, (b) endoscopic view showing fissuring, (c) endoscopic view showing cavitation and delamination, (d) endoscopic view showing fissuring and delamination, and (e) large piece of degenerated disc delaminated of the S1 end plate.

  • Figure 4
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 4

    Top: Age distribution of patients with (right) and without (left) a vacuum phenomenon noted on preoperative x-ray (X-Ray Positive). Bottom: Age distribution of patients with (right) and without (left) intraoperatively visualized vacuum disc.

Tables

  • Figures
  • Table 1
  • Table 2
  • Table 3
  • Table 4
  • Table 5
  • Table 6
  • Table 7
  • Table 8
  • Table 9
  • Table 10
  • Table 11
  • Table 12
PreviousNext
Back to top

In this issue

International Journal of Spine Surgery
Vol. 13, Issue 5
1 Oct 2019
  • Table of Contents
  • Index by author

Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on International Journal of Spine Surgery.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Use of “Inside-Out” Technique for Direct Visualization of a Vacuum Vertically Unstable Intervertebral Disc During Routine Lumbar Endoscopic Transforaminal Decompression—A Correlative Study of Clinical Outcomes and the Prognostic Value of Lumbar Radiograp…
(Your Name) has sent you a message from International Journal of Spine Surgery
(Your Name) thought you would like to see the International Journal of Spine Surgery web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Use of “Inside-Out” Technique for Direct Visualization of a Vacuum Vertically Unstable Intervertebral Disc During Routine Lumbar Endoscopic Transforaminal Decompression—A Correlative Study of Clinical Outcomes and the Prognostic Value of Lumbar Radiographs
KAI-UWE LEWANDROWSKI, JORGE FELIPE RAMÍREZ LEÓN, ANTHONY YEUNG
International Journal of Spine Surgery Oct 2019, 13 (5) 399-414; DOI: 10.14444/6055

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Use of “Inside-Out” Technique for Direct Visualization of a Vacuum Vertically Unstable Intervertebral Disc During Routine Lumbar Endoscopic Transforaminal Decompression—A Correlative Study of Clinical Outcomes and the Prognostic Value of Lumbar Radiographs
KAI-UWE LEWANDROWSKI, JORGE FELIPE RAMÍREZ LEÓN, ANTHONY YEUNG
International Journal of Spine Surgery Oct 2019, 13 (5) 399-414; DOI: 10.14444/6055
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • ABSTRACT
    • INTRODUCTION
    • MATERIALS AND METHODS
    • RESULTS
    • DISCUSSION
    • CONCLUSION
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • A Differential Clinical Benefit Examination of Full Lumbar Endoscopy vs Interspinous Process Spacers in the Treatment of Spinal Stenosis: An Effect Size Meta-Analysis of Clinical Outcomes
  • Difficulties, Challenges, and the Learning Curve of Avoiding Complications in Lumbar Endoscopic Spine Surgery
  • Endoscopic Transforaminal Lumbar Interbody Fusion With a Single Oblique PEEK Cage and Posterior Supplemental Fixation
  • Artificial Intelligence Comparison of the Radiologist Report With Endoscopic Predictors of Successful Transforaminal Decompression for Painful Conditions of the Lumber Spine: Application of Deep Learning Algorithm Interpretation of Routine Lumbar Magnetic Resonance Imaging Scan
  • Google Scholar

More in this TOC Section

  • Comparative Review of Lateral and Oblique Lumbar Interbody Fusion: Technique, Outcomes, and Complications
  • Key Considerations in Surgical Decision-Making on the Side of Approach for Lumbar Lateral Transpsoas Interbody Fusion Techniques
  • A Spine Surgeon’s Learning Curve With the Minimally Invasive L5 to S1 Lateral ALIF Surgical Approach: Perioperative Outcomes and Technical Considerations
Show more Minimally Invasive Surgery

Similar Articles

Keywords

  • disc vacuum phenomenon
  • lumbar endoscopic transforaminal decompression

Content

  • Current Issue
  • Latest Content
  • Archive

More Information

  • About IJSS
  • About ISASS
  • Privacy Policy

More

  • Subscribe
  • Alerts
  • Feedback

Other Services

  • Author Instructions
  • Join ISASS
  • Reprints & Permissions

© 2025 International Journal of Spine Surgery

International Journal of Spine Surgery Online ISSN: 2211-4599

Powered by HighWire