Interlaminar Biportal Endoscopic Lumbar Discectomy: 7 Years of Experience

Gaffar, A.
July 2007
Internet Journal of Minimally Invasive Spinal Technology;2007, Vol. 1 Issue 2, p12
Academic Journal
The purpose of this paper is to detail my experience since 1998, including 'pearls and pitfalls', with the technique of Inter-laminar endoscopic lumbar discectomy. This is a technique in which through two 5 mm portals in the midline of the back, the disc is approached through an inter-laminar approach under endoscopic vision. The scope is introduced through one portal and the working instruments through another portal. The study involves 400 patients operated since 1998 with a modified McNab score of 88% good-excellent results. The learning curve is steep in the beginning but with good grasp of endoscopic anatomy, the technique can be mastered easily. Patients with fair and poor results are analyzed in this study and the reasons have been established which will help a surgeon in his case selection. All the complications encountered are discussed and the pitfalls analyzed. How to improve the endoscopic vision when there is a 'red-out' is also discussed. Endoscopic anatomy is explained. Strategies to master the technique are detailed. Lateral recess stenosis can also be treated endoscopically and this is also explained. Instruments required for the procedure are described along with the surgical technique.


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