Transforaminal endoscopic discectomy: A targeted spinal surgery

• Main Authors: Mor Japar Khan, Ed Simor Khan, Kow, Ren Yi
• Format: Conference or Workshop Item
• Language: English
• Published: 2019
• Subjects: RD701 Orthopedics
• Online Access: http://irep.iium.edu.my/77085/1/MERGED%20Transforminal%20Endoscopic%20Disectomy%20KRD.pdf; http://irep.iium.edu.my/77085/
• Institution: Universiti Islam Antarabangsa Malaysia

Introduction: Open discectomy has been the gold standard of care for cases of the prolapsed intervertebral disc (PID). Tissue dissection is unavoidable in order to access the pathologic disc material. After skin incision, subcutaneous fat tissue, paraspinal muscles, ligamentum flavum, epidural fat, dura and nerve roots have to be encountered before reaching the disc material. With the advent of Minimally Invasive Spine Surgery (MISS) technique, transforaminal endoscopic discectomy has been practised with much success. With this new technique, only skin and subcutaneous tissue need to be breached before reaching the disc material. Also known as the targeted surgical technique, this technique minimized the trauma to the soft tissue. We present a case series of 10 patients with PID which was treated with the new transforaminal endoscopic technique. Anatomy considerations and Surgical Techniques: The anatomic triangle of Kambin is a safe zone where both the exiting and transversing nerve roots are avoided. With the advance of endoscopic equipment, the scope can be introduced into the Kambin triangle to approach the pathologic disc. Result: All 10 patients underwent the transforaminal endoscopic discectomy and achieved good recovery. There was no reported complicated such as infection and nerve root injury. Minimal tissue violation enabled the patients to recover faster and return to work. Conclusion: Early recovery is expected in these patients due to the minimally invasive nature of the surgery. In the future, this might be the gold standard of treating prolapsed intervertebral disc.