A novel surgical concept of transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) for central canal stenosis of the lumbar spine with local anesthesia : A case report and literature review

Koichi Sairyo; Kazuta Yamashita; Hiroaki Manabe; Yoshihiro Ishihama; Kosuke Sugiura; Fumitake Tezuka; Yoichiro Takata; Toshinori Sakai; Yasuyuki Omichi; Nobutoshi Takamatsu; Ayaka Hashimoto; Toru Maeda

doi:10.2152/jmi.66.224

A novel surgical concept of transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) for central canal stenosis of the lumbar spine with local anesthesia : A case report and literature review

Koichi Sairyo, Kazuta Yamashita, Hiroaki Manabe, Yoshihiro Ishihama, Kosuke Sugiura, Fumitake Tezuka, Yoichiro Takata, Toshinori Sakai, Yasuyuki Omichi, Nobutoshi Takamatsu, Ayaka Hashimoto, Toru Maeda

Author information

Koichi Sairyo
Department of Orthopedics, Tokushima University, Tokushima, Japan
Kazuta Yamashita
Department of Orthopedics, Tokushima University, Tokushima, Japan
Hiroaki Manabe
Department of Orthopedics, Tokushima University, Tokushima, Japan
Yoshihiro Ishihama
Department of Orthopedics, Tokushima University, Tokushima, Japan
Kosuke Sugiura
Department of Orthopedics, Tokushima University, Tokushima, Japan
Fumitake Tezuka
Department of Orthopedics, Tokushima University, Tokushima, Japan
Yoichiro Takata
Department of Orthopedics, Tokushima University, Tokushima, Japan
Toshinori Sakai
Department of Orthopedics, Tokushima University, Tokushima, Japan
Yasuyuki Omichi
Department of Orthopedics, Tokushima University, Tokushima, Japan
Nobutoshi Takamatsu
Department of Orthopedics, Tokushima University, Tokushima, Japan
Ayaka Hashimoto
Department of Orthopedics, Tokushima University, Tokushima, Japan
Toru Maeda
Department of Orthopedics, Tokushima University, Tokushima, Japan

Keywords: transforaminal full-endoscopic lumbar decompression, central stenosis, undercutting laminectomy

JOURNAL FREE ACCESS

2019 Volume 66 Issue 3.4 Pages 224-229

DOI https://doi.org/10.2152/jmi.66.224

Details

Abstract

Full-endoscopic spinal surgery was first developed for the lumbar herniated nucleus pulposus. Mainly, there are two types in the full-endoscopic lumbar surgery : i.e., transforaminal (TF) and interlaminar approach. The surgery can be done under the local anesthesia for the TF approach ; therefore, we need to further develop the TF approach to variety of the spinal disorders. Recently, the TF full-endoscopic surgery has been applied for the spinal canal stenosis. First, transforaminal full-endoscopic lumbar foraminoplasty for the foraminal stenosis ; then, transforaminal lumbar lateral recess decompression for the lateral recess stenosis has been developed. Finally, we have developed the surgical technique to decompress the central stenosis via TF approach under the local anesthesia. Prior to initiate the clinical case, we have attempted the lumbar undercutting laminectomy using a fresh cadaveric spine. After we technically confirmed that the transforaminal full-endoscopic lumbar undercutting laminectomy (TE-LUL) is possible, we applied the technique to the patient whose lung capacity did not allow general anesthesia. The 72 years old female patient with central canal stenosis could be improved her left leg pain and muscle weakness after TE-LUL under the local anesthesia. In this paper, we introduce the surgical technique of the TE-LUL and discuss of the efficacy of the TE-LUL. J. Med. Invest. 66 : 224-229, August, 2019

Corresponding author

Register with J-STAGE for free!