PMID- 37373901
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230701
IS  - 2075-4426 (Print)
IS  - 2075-4426 (Electronic)
IS  - 2075-4426 (Linking)
VI  - 13
IP  - 6
DP  - 2023 May 30
TI  - Microendoscopic Surgery for Degenerative Disorders of the Cervical and Lumbar 
      Spine: The Influence of the Tubular Workspace on Instrument Angulation, Clinical 
      Outcome, Complications, and Reoperation Rates.
LID - 10.3390/jpm13060912 [doi]
LID - 912
AB  - BACKGROUND: Long-term clinical outcomes with microendoscopic spine surgery (MESS) 
      are poorly investigated. The effect of instrument angulation on clinical outcomes 
      has yet to be assessed. METHODS: A total of 229 consecutive patients operated on 
      via two MESS systems were analyzed. Instrument angulation for both MESS systems, 
      which differ from each other regarding the working space for instruments, was 
      assessed using a computer model. Patients' charts and endoscopic video recordings 
      were reviewed to determine clinical outcomes, complications, and revision surgery 
      rates. At a minimum follow-up of two years, clinical outcomes were assessed 
      employing the Neck Disability Index (NDI) and Oswestry Disability Index (ODI). 
      RESULTS: A total of 52 posterior cervical foraminotomies (PCF) and 177 lumbar 
      decompression procedures were performed. The mean follow-up was six years (range 
      2-9 years). At the final follow-up, 69% of cervical and 76% of lumbar patients 
      had no radicular pain. The mean NDI was 10%, and the mean ODI was 12%. PCF 
      resulted in excellent clinical outcomes in 80% of cases and 87% of lumbar 
      procedures. Recurrent disc herniations occurred in 7.7% of patients. The surgical 
      time and repeated procedure rate were significantly lower for the MESS system 
      with increased working space, whereas the clinical outcome and rate of 
      complication were similar. CONCLUSIONS: MESS achieves high success rates for 
      treating degenerative spinal disorders in the long term. Increased instrument 
      angulation improves access to the compressive pathology and lowers the surgical 
      time and repeated procedure rate.
FAU - Oertel, Joachim M
AU  - Oertel JM
AD  - Klinik fur Neurochirurgie, Universitat des Saarlandes, Kirrbergerstrasse 100, 
      66421 Homburg-Saar, Germany.
FAU - Burkhardt, Benedikt W
AU  - Burkhardt BW
AD  - Wirbelsaulenzentrum/Spine Center-WSC, Klinik Hirslanden, Witellikerstrasse 40, 
      8032 Zurich, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20230530
PL  - Switzerland
TA  - J Pers Med
JT  - Journal of personalized medicine
JID - 101602269
PMC - PMC10305584
OTO - NOTNLM
OT  - cervical spine
OT  - clinical outcome
OT  - complication
OT  - degenerative disc disease
OT  - endoscopy
OT  - instrument angulation
OT  - lumbar spine
OT  - microendoscopic
OT  - reoperation
COIS- J.M.O. is a consultant, holds patents of the EasyGO system, and received a 
      speaker honorarium for education from the Karl Storz Company without the 
      influence of the study results. B.W.B. has nothing to disclose.
EDAT- 2023/06/28 06:42
MHDA- 2023/06/28 06:43
PMCR- 2023/05/30
CRDT- 2023/06/28 01:23
PHST- 2023/04/12 00:00 [received]
PHST- 2023/05/19 00:00 [revised]
PHST- 2023/05/26 00:00 [accepted]
PHST- 2023/06/28 06:43 [medline]
PHST- 2023/06/28 06:42 [pubmed]
PHST- 2023/06/28 01:23 [entrez]
PHST- 2023/05/30 00:00 [pmc-release]
AID - jpm13060912 [pii]
AID - jpm-13-00912 [pii]
AID - 10.3390/jpm13060912 [doi]
PST - epublish
SO  - J Pers Med. 2023 May 30;13(6):912. doi: 10.3390/jpm13060912.