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Research ArticleArticle
Open Access

Endoscopic Trans-iliac Approach to L5-S1 Disc and Foramen – A Report on Clinical Experience

Said G Osman, Sandeep Sherlekar, Atif Malik, Charles Winters, PK Grewal, Malini Narayanan and Nigussie Gemechu
International Journal of Spine Surgery January 2014, 8 20; DOI: https://doi.org/10.14444/1020
Said G Osman
American Spine, Germantown, MD
MD, FAAOS, FRCSEd (ortho)
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Sandeep Sherlekar
American Spine, Germantown, MD
MD
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Atif Malik
American Spine, Germantown, MD
MD
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Charles Winters
American Spine, Germantown, MD
MD
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PK Grewal
American Spine, Germantown, MD
MD
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Malini Narayanan
American Spine, Germantown, MD
MS, MD
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Nigussie Gemechu
American Spine, Germantown, MD
MS
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Figures

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    Fig. 1

    a) Trans-iliac window is 4.16 cm anterolateral to the posterosuperior iliac spine; b) trans-iliac track is posterior to the sacral ala, and cephalad to the S1 pedicle; c) trans-iliac track does not violate the retroperitoneal space, and is safe distance from the lumbosacral trunk; d) the superior gluteal neurovascular bundle is 4.8 cm caudal to the trans-iliac window; e) trans-iliac access portal and its anatomic relationships.

  • Fig. 2
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    Fig. 2
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    Fig. 3
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    Fig. 4
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    Fig. 5
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    Fig. 6

    A: Arthroscope in place; B: using grasping forceps to remove disc; C: disc fragments removed.

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    Fig. 7

    A 3D CT scan of the lumboscacral junction showing a trans-iliac guidewire tracking posterior to the sacral ala, into the posterolateral L5-S1 disc transforaminally.

  • Fig. 8
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    Fig. 8

    Pre- and postoperative leg pain.

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    Fig. 9

    Pre- and postoperative low back pain.

  • Fig. 10
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    Fig. 10

    Pre- and postoperative ODI.

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International Journal of Spine Surgery
Vol. 8
1 Jan 2014
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Endoscopic Trans-iliac Approach to L5-S1 Disc and Foramen – A Report on Clinical Experience
Said G Osman, Sandeep Sherlekar, Atif Malik, Charles Winters, PK Grewal, Malini Narayanan, Nigussie Gemechu
International Journal of Spine Surgery Jan 2014, 8 20; DOI: 10.14444/1020

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Endoscopic Trans-iliac Approach to L5-S1 Disc and Foramen – A Report on Clinical Experience
Said G Osman, Sandeep Sherlekar, Atif Malik, Charles Winters, PK Grewal, Malini Narayanan, Nigussie Gemechu
International Journal of Spine Surgery Jan 2014, 8 20; DOI: 10.14444/1020
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Keywords

  • percutaneous
  • endoscopic
  • trans-iliac
  • trans-foraminal
  • iliac crest

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