著者

Koichi Sairyo Kosaku Higashino Kazuta Yamashita Fumio Hayashi Keizo Wada Toshinori Sakai Yoichiro Takata Fumitake Tezuka Masatoshi Morimoto Tomoya Terai Takashi Chikawa Hiroshi Yonezu Akihiro Nagamachi Yoshihiro Fukui

出版者

徳島大学医学部

雑誌

The Journal of Medical Investigation (ISSN:13431420)

巻号頁・発行日

vol.64, no.1.2, pp.1-6, 2017 (Released:2017-03-29)

参考文献数

32

被引用文献数

31

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Percutaneous endoscopic surgery for the lumbar spine, which was established in the last decade, requires only an 8-mm skin incision and causes minimal damage to the paravertebral muscles; thus, it is considered to be a minimally invasive technique for spinal surgery. It has been used to perform percutaneous endoscopic discectomy via two main approaches: the TF approach is a posterolateral one through the intervertebral foramen and can be done under local anesthesia; the IL approach is a more traditional one through the interlaminar space and is difficult to perform under local anesthesia. Recently, these techniques have been applied for lumbar spinal stenosis (LSS), the TF method for foraminal stenosis under local anesthesia, and the IL method for central and lateral recess stenosis under general anesthesia. In this study, using a fresh human cadaver model, we performed simultaneous decompression of the lateral recess and foraminal stenosis at L4-5 using the TF approach. Computed tomography confirmed enlargement of the lateral recess and intervertebral foramen. This technique, which can be performed under local anesthesia, should benefit elderly patients with LSS and poor general condition due to multiple comorbidities. Finally, we introduce the concept of percutaneous transforaminal ventral facetectomy using a spinal percutaneous endoscope. J. Med. Invest. 64: 1-6, February, 2017