This video presents a case of L4–5 unstable spondylolisthesis treated with full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), emphasizing the GUARD (Glider Used as a Rotary Device) technique for nerve root protection. This innovative approach involves controlled rotation of the cage glider before cage insertion to minimize the risk of nerve root injury, a significant complication in Endo-TLIF procedures. The GUARD technique, validated in previous cadaveric studies, provides enhanced safety during cage insertion by protecting the nerve root. A 48-year-old woman with a 3-year history of progressive low back pain and bilateral lower extremity radiculopathy (right-sided predominance) was diagnosed with L4–5 unstable spondylolisthesis and spinal stenosis. After failure of conservative management, she underwent uniportal full-endoscopic facet-resecting transforaminal lumbar interbody fusion using the GUARD technique. Postoperatively, the patient experienced significant symptomatic improvement and resolution of radiculopathy, without any intraoperative nerve root injury or postoperative neurological deficits. This case demonstrates the effectiveness of the GUARD technique in reducing neurological complications and improving patient outcomes.
Citations
Citations to this article as recorded by
Cage design-centric glider approach to full-endoscopic lumbar fusion: optimizing nerve root protection in facet-sparing and facet-resecting techniques Yu-Chia Hsu, Hao-Chun Chuang, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Hyeun-Sung Kim, Cheng-Li Lin Asian Spine Journal.2026; 20(2): 343. CrossRef
Innovative method for efficient placement of a working cannula in uniportal transarticular full-endoscopic lumbar interbody fusion: transarticular trephonic plasty (TTP) Wei Jiao, Wen Yin, Xilong Cui, Wei Wang, Yukai Cui, Xiaohao Sun, Tao Sun, Junyou Hu, Jianqiang Zhang, Haiyang Yu BMC Musculoskeletal Disorders.2026;[Epub] CrossRef
Robotic-Assisted Uniportal Full-Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Note on a Hybrid Form of Minimally Invasive Surgery Ting Yao Ang, A. Aravin Kumar, Chin Hong Ngai, John J.Y. Zhang, Jacob Y.L. Oh, Ji Min Ling, Thomas C.H. Tan Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 105. CrossRef
Exoscopic Extraforaminal Lumbar Interbody Fusion for Lumbar Degenerative Disease: Technical Considerations and Clinical Outcomes During the Early Learning Curve Kentaro Yamane, Shinichiro Takao, Kanji Sasaki, Wataru Narita, Hisakazu Shitozawa, Kazuhiro Takeuchi, Shinnosuke Nakahara Journal of Clinical Medicine.2026; 15(9): 3516. CrossRef
Clinical and Radiological Outcomes of Double-Cage Full Endoscopic Transforaminal Lumbar Interbody Fusion Compared with Posterior Lumbar Interbody Fusion : A Retrospective Cohort Study Chi Ho Kim, Pius Kim, Chang Il Ju, Jong Hun Seo Journal of Korean Neurosurgical Society.2026; 69(4): 596. CrossRef
This review aims to systematically evaluate the incidence, management strategies, and clinical outcomes of iatrogenic durotomy (ID) in endoscopic spine surgery and to propose a management flowchart based on the tear size and associated complications. A comprehensive literature search was conducted, focusing on studies involving endoscopic spinal procedures and incidental durotomy. The selected studies were analyzed for management techniques and outcomes, particularly in relation to the size of the dural tear and the presence of nerve root herniation. Based on these findings, a flowchart for intraoperative management was developed. A total of 14 studies were included, encompassing 68,546 patients. Varying incidences of ID, with management strategies largely dependent on the size of the dural tear, were found. Small tears (less than 5 mm) were often left untreated or managed with absorbable hemostatic agents, while medium (5–10 mm) and large tears (greater than 10 mm) required more complex approaches like endoscopic patch repair or open surgery. The presence of nerve root herniation necessitated immediate action, often influencing the decision to convert to open repair. Effective management of ID in endoscopic spine surgery requires a nuanced approach tailored to the size of the tear and specific intraoperative challenges, such as nerve root herniation. The proposed flowchart offers a structured approach to these complexities, potentially enhancing clinical outcomes and reducing complication rates. Future research with more rigorous methodologies is necessary to refine these management strategies further and broaden the applications of endoscopic spine surgery.
Citations
Citations to this article as recorded by
Disc Level–Specific outcomes of intradiscal condoliase injection for lumbar disc herniation: A multicenter retrospective study Kota Watanabe, Yohei Takahashi, Takehiro Michikawa, Takuya Takahashi, Tomohiro Banno, Kyohei Sakaki, Yoshiyasu Arai, Yuichi Takano, Yawara Eguchi, Yuki Taniguchi, Satoshi Maki, Yasuchika Aoki, Shunichi Fujii, Kentaro Sakaeda, Yu Matsukura, Tsutomu Akazawa Journal of Orthopaedic Science.2026; 31(3): 521. CrossRef
Beyond the Microscope: Is Endoscopic Discectomy the Next Gold Standard for Lumbar Disc Herniation? Borriwat Santipas, Jin Sung Kim, Korawish Mekariya, John Y.S. Choi, Samuel K. Cho Neurospine.2026; 23(1): 61. CrossRef
A Systematic Review of Complication Management During Uniportal and Biportal Endoscopic Spine Surgery: Dural Tear and Bleeding Siravich Suvithayasiri, Ju Eun Kim, Facundo Van Isseldyk, Marcus Serra, Christopher Martin, Viswanadha Arunkumar, Sotirios Veranis, Prashanth Rao, Enrico Giordan, Piya Chavalparit, Nelson Astur, Samuel Cho, Jin Sung Kim Global Spine Journal.2026;[Epub] CrossRef
Classification of endoscopic spine procedures Mazda Farshad, Christoph J. Laux, Florian Wanivenhaus, José M. Spirig, Jonas Widmer, Michael Kelly, Javier Quillo-Olvera, Jin-Sung Kim, Facundo van Isseldyk, Sohrab Gollogly, James Yue, Xuexiao Ma, Vincent Hagel, Frédéric Cornaz North American Spine Society Journal (NASSJ).2025; 22: 100603. CrossRef
Full-endoscopic dural repair using drain catheter: technical note Peter Van Daele, Piya Chavalparit, Borriwat Santipas, Jin-Sung Kim Acta Neurochirurgica.2025;[Epub] CrossRef
Transdural rootlet herniation– An exceptional complication of full endoscopic lumbar discectomy: case reports and review of literature Kandarpkumar K. Patel, Siravich Suvithayasiri, Yanting Liu, Jin-Sung Kim European Spine Journal.2025; 34(10): 4455. CrossRef
Intracranial Embolism After a Dural Tear in Endoscopic Spine Surgery Jae Won Shin, Si Young Park, Hak Sun Kim, Kyung Soo Suk, Seong Hwan Moon, Dong Hee Ye JBJS Case Connector.2025;[Epub] CrossRef
Commentary on “Intraoperative Management of Iatrogenic Durotomy in Endoscopic Spine Surgery: A Systematic Review” Andrew J. Berg, Prashanth J. Rao Neurospine.2024; 21(3): 767. CrossRef
From the Editor-in-Chief: Featured Articles in the September 2024 Issue Inbo Han Neurospine.2024; 21(3): 743. CrossRef
Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration Warayos Trathitephun, Jackapol Kamolpak, Siravich Suvithayasiri Neurospine.2024; 21(4): 1102. CrossRef
A Commentary on “Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration” David Del Curto Neurospine.2024; 21(4): 1106. CrossRef
Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique Yu-Chia Hsu, Hao-Chun Chuang, Wei-Lun Chang, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Hyeun-Sung Kim, Cheng-Li Lin Neurospine.2024; 21(4): 1141. CrossRef
Objective Although endoscopic drill has the advantages in manipulation and hemostasis, whose low efficiency and blurred vision reduce the efficacy of lumbar endoscopic unilateral laminotomy with bilateral decompression (LE-ULBD). The present study was designed to evaluate the safety and efficacy of full-visualized trephine/osteotome in the LE-ULBD surgery for severe lumbar stenosis.
Methods Fifty-seven severe lumbar stenosis patients who underwent LE-ULBD between January 2020 to January 2023 were enrolled, who were divided into drill and visualized trephine groups. The medical records including demographics, operative duration, intraoperative electrophysiological findings, postoperative hospital stay or hospital stay, postoperative outcomes and complications were retrospectively reviewed and analyzed.
Results A total of 57 patients included 15 in drill and 42 in trephine group were enrolled in the study. There was significant difference in the pre- and postoperative visual analogue scale and Oswestry Disability Index scores in both groups (p < 0.05). The mean operative duration in the trephine group (101.05 ± 12.18 minutes) was shorter than that in the drill group (134.67 ± 9.68 minutes) (p < 0.05). There was no statistical difference between the 2 groups in electrophysiological monitoring, posthospital stays, postoperative outcomes and complications. Abnormal free-electromyography (EMG) were recorded in 2 (13.3%) and 5 patients (11.9%) in the drill and trephine group. Intraoperative somatosensory evoked potential changes occurred in 3 (20%) and 3 patients (7.1%) in the drill and trephine group and all patients recovered immediately when surgery ended. No serious complications and recurrence occurred in all the patients.
Conclusion Full-visualized trephine/osteotome has been approved to be convenient, safe and efficient in our study, which combined with translaminar inside-out technique and EMG monitoring especially free-EMG may offer a new choice in LE-ULBD surgery for lumbar stenosis patients.
Citations
Citations to this article as recorded by
Clinical outcomes of unpowered osteotome-assisted unilateral biportal endoscopy (UBE) for the treatment of lumbar spinal stenosis: a retrospective cohort study Weiran Hu, Hongqiang Wang, Haoxu Wang, Chuang Wang, Xinge Shi, Yanzheng Gao, Kai Zhang European Journal of Medical Research.2026;[Epub] CrossRef
Cost-effectiveness analysis of extended endoscopic lumbar foraminotomy (EELF) and transforaminal lumbar interbody fusion (TLIF): a prospective observational study Jun-Hoe Kim, Hangeul Park, Chang-Hyun Lee, Chi Heon Kim Scientific Reports.2025;[Epub] CrossRef
Establishing a Staging System for Adjacent Segment Disease and Exploring Its Significance in Guiding Surgical Decisions: A Retrospective Study Changpeng Qu, Jianwei Guo, Hao Tao, Chuanli Zhou, Kai Zhu, Yihao Sun, Lei Li, Zhiming Liu, Hao Zhang, Xuexiao Ma Orthopaedic Surgery.2025; 17(5): 1418. CrossRef
Comparison of treatment outcomes and analysis of factors interfering with efficacy in patients with lumbar spinal stenosis undergoing unilateral unichannel and bichannel endoscopic ULBD surgery Jie Ma, Fei Chen, Zeyuan Zhu, Tong Liao, Hengjun Wang Journal of Orthopaedic Surgery and Research.2025;[Epub] CrossRef
Objective Multilevel or revisional posterior spinal surgery is prone to infection and delayed wound healing, related with the wound closure time and suture strength. Knotless barbed suture is an innovative self-locking, multianchor suture. This study aims to evaluate the safety and efficacy of the knotless barbed suture and self-adhering mesh with polymeric glue in multilevel or revisional posterior spinal surgery.
Methods This is a single-center retrospective matched cohort study. Patients were divided into 2 groups based on the wound closure method: barbed suture group with novel wound closure, and conventional suture group with conventional wound closure, 1:1 matched by the level of surgery and sex, resulting in 120 subjects each. Total operation time and wound closure time were measured intraoperatively, and perioperative clinical outcome parameters including postoperative wound complication were investigated for the first 3 months postoperatively. The distribution of continuous variables was assessed for normality by Shapiro-Wilk test, then parametric or nonparametric tests were applied accordingly (paired t-test or Wilcoxon signed-rank test).
Results Wound closure time was significantly shorter with the novel barbed suture than with conventional suture in all subgroups divided by the level of spinal surgery: 3–5, 6–9, ≥ 10 levels (p < 0.001). The 2 groups showed no significant differences in surgical complications (p = 1.000). Specially, total operation time and wound-closing time were significantly shorter in revisional subgroup.
Conclusion Absorbable knotless barbed suture and self-adhering mesh with polymeric glue can shorten spinal wound closure time with noninferiority in complications for multilevel or revisional spinal surgery.
Citations
Citations to this article as recorded by
Barbed Versus Conventional Suture for Spinal Surgery: A Systematic Review and Meta-Analysis Hugo Nunes Pustilnik, Gabriel Araújo Cerqueira, Jefferson Heber Marques Fontes, Davi Amorim Meira, Gabriel Souza Medrado-Nunes, Beatriz Lopes Bernardo da Cunha, Silvio Porto Junior, Matheus Gomes da Silva da Paz, Tancredo Alcântara, Leonardo Miranda de Av World Neurosurgery.2025; 193: 241. CrossRef
Expanded applications of knotless tissue control devices in neurosurgical cranial and spinal applications Samuel A. Tenhoeve, Clayton Rawson, Dora R. Tabachnick, Mohammed A. Azab, Omowumi Oladipo, Michael Karsy Journal of Clinical Neuroscience.2025; 134: 111108. CrossRef
Clinical Outcomes Among Patients Undergoing Open Abdominal or Orthopedic Surgery with Wound Closure Incorporating Triclosan-Coated Barbed Sutures: A Multi-Institutional, Retrospective Database Study Stephen Fortin, Kerstin Spychaj, Jörg Tomaszewski, Holly Grebeck, Rithwik Yalla, Paul Coplan, Shumin Zhang Medical Devices: Evidence and Research.2025; Volume 18: 161. CrossRef
Adhesive Strips vs. Sutures in Lumbar Spinal Fusion: A Non-inferiority Analysis of Surgical Site Infections Fernando A Núñez-Moreno, Christian Bepperling, Carlos Trenado, Steffen Eitelbuss, Karen Velázquez, Vasilis Karantzoulis, Maria C Ochoa Estrada, Edgar Santos, Farzam Vazifehdan Cureus.2025;[Epub] CrossRef
Femtosecond laser micromachining of barbed sutures Walid Al Asad, Shubha Majumder, Karuna Nambi Gowri, Martin W. King, Xin Zhao Manufacturing Letters.2025; 44: 517. CrossRef
Assessing the application of barbed sutures in comparison to conventional sutures for surgical applications: a global systematic review and meta-analysis of preclinical animal studies Nanyan Xiang, Yifei Lin, Xiaoyi Su, Zifan Hu, Jinyu Zhou, Yi Wu, Liang Du, Jin Huang International Journal of Surgery.2024; 110(5): 3060. CrossRef
“Revolutionising spinal surgery: the impact of STRATAFIX™ symmetric barbed sutures on closure time and costs” Ume Aiman, Umer Bin Shahzad Neurosurgical Review.2024;[Epub] CrossRef
Letter to the editor: Prospective analysis of STRATAFIX™ symmetric PDS plus suture for fascial closure in spinal surgery: a pilot study Ume Aiman Neurosurgical Review.2024;[Epub] CrossRef
“Evaluating wound closure innovations in spinal surgery: impacts on efficiency and patient outcomes” Muhammad Ahmed, Manal Nadeem, Umer Bin Shahzad, Humzah Salim Neurosurgical Review.2024;[Epub] CrossRef
Barbed sutures versus conventional sutures for wound closure in spine surgeries: a systematic review and meta-analysis Khalid Sarhan, Reem Reda Elmahdi, Rashad G. Mohamed, Ibrahim Serag, Mohamed Abouzid Neurosurgical Review.2024;[Epub] CrossRef
Objective Based on traditional dual growing rods (TDGR), apical control techniques (ACTs) were introduced as adjuvant procedures to improve deformity correction at the apex segment in the treatment of early-onset scoliosis (EOS). We aimed to explore whether TDGR+ ACTs have different indications, attain more deformity correction, have negative effects on spinal growth, and have different complications.
Methods Between 2004 and 2019, a retrospective study of EOS patients treated with TDGR with or without ACTs was conducted and divided into 3 groups: TDGR group; hybrid technique (HT) group: Vertebrectomy/hemivertebrectomy with short fusion and TDGR; ACPS group: apical convex control pedicle screws (ACPS) and TDGR. Demographic, radiographic parameters, clinical outcomes, complications, and revisions were analyzed and compared.
Results Seventy-eight EOS patients were enrolled. The preoperative main curve was the largest in the HT group. ACPS group had the smallest residual curve (19° ± 8.9°) and apical vertebral translation (12.0 ± 9.0 mm) at the latest follow-up, followed by the HT group (30° ± 17.4°, 22.1 ± 13.4 mm) and TDGR group (30° ± 13.2°, 32.8 ± 17.1 mm). ACPS group had the largest T1–12 height and T1–S1 height after index surgery. Complications and revisions in the ACTs groups was lower than the TDGR group. Scoliosis Research Society-22 self-image questionnaire was superior in the ACPS group.
Conclusion According to our intermediate results, TDGR+ACTs could improve correction ability of apex deformity. ACTs had little deleterious effects on spinal height during the lengthening procedures, with a lower complication rate than TDGR. TDGR+ACTs might be a supplemental option for suitable EOS patients.
Citations
Citations to this article as recorded by
Current Knowledge of Respiratory Function in Early Onset Scoliosis and the Effect of Its Contemporary Surgical Treatment Sai Gautham Balasubramanian, David Fender, Paul Rushton Journal of Clinical Medicine.2026; 15(2): 754. CrossRef
Outcomes of Traditional Dual Growing Rods With Apical Control Techniques for the Treatment of Early-Onset Scoliosis: Comparison With Patients Treated With Traditional Dual Growing Rods Only With a Minimum 2-Year Follow-up After Graduation Chenkai Li, Xiaohan Ye, Yang Yang, Guanfeng Lin, Jianxiong Shen, Yu Zhao, Nan Wu, Qianyu Zhuang, Shengru Wang, Jianguo Zhang Neurosurgery.2025; 96(5): 975. CrossRef
Advances in the diagnosis and treatment of congenital scoliosis Zhiming Peng, Haoran Zhang, Shengru Wang, Jianguo Zhang European Journal of Medical Research.2025;[Epub] CrossRef
Objective The surgical treatment of lower cervical facet dislocation is controversial. Great advancements on reduction techniques for lower cervical facet dislocation have been made in the past decades. However, there is no article reviewing all the reduction techniques yet. The aim is to review the evolution and advancements of the reduction techniques for lower cervical facet dislocation.
Methods The application of all reduction techniques for lower cervical facet dislocation, including closed reduction, anterior-only, posterior-only, and combined approach reduction, is reviewed and discussed. Recent advancements on the novel techniques of reduction are also described. The principles of various techniques for reduction of cervical facet dislocation are described in detail.
Results All reduction techniques are useful. The anterior-only surgical approach appears to be the most popular approach. Moreover, many novel or modified reduction and fixation methods have been introduced in recent years.
Conclusion The selection of surgical approach depends on a combination of factors, including surgeon preference, patient factors, injury morphology, and inherent advantages and disadvantages of any given approach.
Citations
Citations to this article as recorded by
Predictive Factors for Failure of Closed Reduction in Traumatic Cervical Facet Dislocations: A Systematic Review of 631 Patients Jorge Tabilo, Andrei F. Joaquim Global Spine Journal.2026; 16(4): 1999. CrossRef
Does the treatment of cervicothoracic junction fractures differ from subaxial cervical fractures? A narrative review Ratko Yurac, Gaurav Raj Dhakal, Andrei Joaquim, Guillermo Ricciardi, Cezar Popescu, Klaus Schnake, Richard Bransford, Gregory Schroeder, Mohammad El-Sharkawi, Sebastian Bigdon, Mohamed M. Aly Journal of Clinical Orthopaedics and Trauma.2026; 73: 103351. CrossRef
Variations in Managing Acute Spinal Cord Injury in the North American Clinical Trials Network and Partner Institutes Teleale Fikru Gebeyehu, Zachary Sokol, James D. Guest, Joseph D. Harrington, Ashmal Sami Kabani, Evan Fitchett, Alejandro Lopez, Stavros Matsoukas, Daniel Franco, Jack Jallo, Alexander R. Vaccaro, Muhammad Abd-El-Barr, Shekar N. Kurpad, Charles H. Tator, Global Spine Journal.2026;[Epub] CrossRef
Awake closed manual reduction of cervical spine dislocation as an emergency bridge to surgery: a case report Fangzheng Lin, Ji Qi, Jing Li, Jianglin Wu, Yu Hou, Minshan Feng, Yongjin Li, Shudong Chen, Dingkun Lin Frontiers in Medicine.2026;[Epub] CrossRef
Subaxial cervical spine fractures with facet joint dislocation: Surgical management, technique, and results in a retrospective series of 36 patients Angelo Rusconi, Stefano Peron, Delia Cannizzaro, Alberto Campione, Roberto Stefini Journal of Craniovertebral Junction and Spine.2026; 17(3): 279. CrossRef
Closed Manual Reduction of Bilaterally Jumped and Locked Cervical Facets under General Anesthesia: Technical Note Vincy Mathew, Sahar Sorek, Aaron Miller, Christina Moawad, Bruno Lazaro, Stephanie Moawad, Ralph Rahme Journal of Neurological Surgery Part A: Central European Neurosurgery.2026;[Epub] CrossRef
Surgical management protocol for anterior-only reduction and fixation for acute, delayed and old subaxial cervical facet dislocation: a retrospective study of 87 consecutive cases in China Zhengfeng Zhang Asian Spine Journal.2026; 20(3): 515. CrossRef
Effects of excessive distraction during anterior cervical spine surgery: a systematic review and meta-analysis of clinical outcomes, radiological changes, and complications Alexander Erick Purnomo, Aldi Nanda Kurniawan, Yang Yang Endro Arjuna, Regan Elbert, Jephtah Furano Lumban Tobing European Spine Journal.2026;[Epub] CrossRef
MRI‐Based Surgical Planning for Irreducible Subaxial Cervical Fracture‐Dislocation With Bilateral Locked Facet Joints: A Retrospective Cohort Study Ao Leng, Lingzhi Meng, Jiacheng Li, Song Shi, Mingming Guo, Hailong Yu, Qi Wang Orthopaedic Surgery.2025; 17(6): 1844. CrossRef
Surgical Management of Facet Fracture Dislocations of the Subaxial Spine: A Retrospective Cohort Study Josh Callaway, Hania Shahzad, Shannon Tse, Ashley Frei, Yashar Javidan, Rolando Roberto, Hai Le JAAOS: Global Research and Reviews.2025;[Epub] CrossRef
Total recovery spinal cord injury in cervical 5–6 dislocation: Case reports I Nyoman Semita, Ni Njoman Juliasih, Parama Gandi, Heni Fatmawati International Journal of Surgery Case Reports.2025;[Epub] CrossRef
Halo, Collar, Anterior, or Posterior Fusion? Comparative Outcomes in Typical and Atypical Hangman's Fractures: A Systematic Review of Fusion Rate and Complication Profile Charbel Elias, Ali Daoud, Zeina Nasser, Rama Daoud, Elias Elias World Neurosurgery.2025; 204: 124530. CrossRef
Optimizing surgical strategies for subaxial cervical fracture-dislocation: a facet and disc injury-based approach Shiyong Wang, Rubin Yao, Xiangdong Gong, Xin Miao, Yandong Chu, Kaishun Yang, Zhaohui Ge Frontiers in Surgery.2025;[Epub] CrossRef
Non-traumatic complete cervical spine dislocation with severe fixed kyphosis: successful multidisciplinary approach to a challenging case Camille Lecouvet, Pierre Geradon, Xavier Banse, Gauthier Rausin, Nicolas Guyot, Frederic E. Lecouvet Journal of Medical Case Reports.2024;[Epub] CrossRef
Traumatic Cervical Facet Fractures and Dislocations Jesse Wang, Abhishek Kumar, Adam L. Shimer, Brian W. Su Clinical Spine Surgery.2024; 37(9): 404. CrossRef
An Update on Spinal Cord Injury and Current Management Austin H. Carroll, Edward Fakhre, Alejandro Quinonez, Oliver Tannous, Addisu Mesfin JBJS Reviews.2024;[Epub] CrossRef
Adult cervical spine deformity is associated with decreased health-related quality of life, disability, and myelopathy. A number of radiographic parameters help to characterize cervical deformity and aid in the diagnosis and treatment. There are several etiologies for cervical spine deformity, the most common being iatrogenic. Additionally, spine surgery can accelerate adjacent segment degeneration which may lead to deformity. It is therefore important for all spine surgeons to be aware of the potential to cause iatrogenic cervical deformity. The aim of this review is to highlight concepts and techniques to prevent cervical deformity after spine surgery.
Citations
Citations to this article as recorded by
Impact of T1 Slope as a Predictor of Loss of Cervical Lordosis and Health-Related Quality of Life after Laminoplasty in Patients with Ossification of the Posterior Longitudinal Ligament : A Retrospective Cohort Study Ji-Ho Jung, Jong-Hoon Jeong, Jong-Hwan Hong, Moon-Soo Han, Jung-Kil Lee Journal of Korean Neurosurgical Society.2026; 69(1): 124. CrossRef
Comparison of cervical alignment between electromagnetic and traction-based head positioning systems Jonathan N. Sembrano, Dustin J. Kress, Regan Carlson, Jason J. Haselhuhn, Jacqueline E. Wright, Paul Brian O. Soriano, Kari Odland World Neurosurgery: X.2026; 31: 100595. CrossRef
The Variability of the Cervicothoracic Inflection Point: A Cohort Analysis of the Multi-Ethnic Asymptomatic Normative Study (MEANS) Justin L. Reyes, Roy Miller, Matan Malka, Josephine Coury, Yong Shen, Natalia Czerwonka, Alexandra Dionne, Jean-Charles Le Huec, Stephane Bourret, Kazuhiro Hasegawa, Hee Kit Wong, Gabriel Liu, Hwee Weng Dennis Hey, Hend Riahi, Michael Kelly, Lawrence G. L Global Spine Journal.2025; 15(4): 2409. CrossRef
Commentary: Cervicothoracic Deformity in the Setting of Adhesive Arachnoiditis: An Operative Video Article Ranbir Ahluwalia, Harsh Jain, Scott L. Zuckerman Operative Neurosurgery.2025; 29(1): 158. CrossRef
Risk factors associated with distal junctional kyphosis and failure after surgical management of adult cervical deformity: a systematic review Davin C. Gong, Anthony N. Baumann, Zhaorui Wang, Omkar S. Anaspure, Muhammad Waheed, Evan J. Beck, Rakesh D. Patel, Ilyas S. Aleem European Spine Journal.2025; 34(8): 3430. CrossRef
Long-term loss of intervertebral disc height after posterior cervical surgery for ossification of the posterior longitudinal ligament: a retrospective study with more than 3 years of follow-up Siyuan Qin, Ruomu Qu, Weili Zhao, Ruixin Yan, Yongye Chen, Feifei Zhou, Ning Lang Journal of Orthopaedic Surgery and Research.2025;[Epub] CrossRef
Objective The safety and clinical usefulness of minimally invasive scoliosis surgery (MISS) has been reported in various studies. However, freehand pedicle screwing in MISS remains technically challenging. The purpose of this study is to evaluate the accuracy and safety of pedicle screw placement using the freehand technique in adolescent idiopathic scoliosis (AIS) patients treated with MISS compared to conventional open scoliosis surgery (COSS).
Methods We included 76 patients who underwent deformity correction for AIS. Computed tomography scans were used to assess screw violations divided into 2 groups according to the surgical technique: MISS or COSS. Anterior violations were classified into grade 0, 1 (no contact with internal organs), and 2 (contact with internal organs). Medial and lateral violations were classified into grade 0, 1 ( < 2 mm), and 3 ( ≥ 2 mm). grade 2 were considered critical violations.
Results A total of 630 and 1,174 pedicle screws were inserted in the MISS and COSS groups, respectively. The overall critical violation rates of the MISS and COSS groups were 16.8% (106 screws) and 14.0% (165 screws) (p = 0.116). Medial critical violations on the left side in the middle thoracic region frequently occurred in the MISS group compared to the COSS group (p = 0.003). There were no statistical differences in the complications.
Conclusion Pedicle screw placement using the freehand technique in MISS for AIS patients provided similar accuracy and safety compared to COSS. Pedicle screws inserted on the left side of the middle thoracic region, exhibited more medial critical violations in the MISS group.
Citations
Citations to this article as recorded by
A Comprehensive and Historical Review of Minimally Invasive Scoliosis Surgery in Adolescent Idiopathic Scoliosis: An Analysis of Research Trends and Hotspots Hong Jin Kim, Dong Yun Kim, Jae Hyuk Yang, Jungwook Lim, Seung Woo Suh Journal of Clinical Medicine.2025; 14(16): 5676. CrossRef
Adolescent Idiopathic Scoliosis: Is the Feasible Option of Minimally Invasive Surgery using Posterior Approach? Hong Jin Kim, Lawrence G. Lenke, Javier Pizones, René Castelein, Per D. Trobisch, Mitsuru Yagi, Michael P. Kelly, Dong-Gune Chang Asian Spine Journal.2024; 18(2): 287. CrossRef
Effect of pedicle screw misplacement on the pull-out strength using personalized finite element modeling A. Rouyin, H. Nazemi, N. Arjmand, M.J. Einafshar Computers in Biology and Medicine.2024; 183: 109290. CrossRef
Long-term Outcomes of Posterior Multilevel Crack Osteotomy: Revisional Surgery for Scoliosis With a Fusion Mass Mi Hyun Song, Jae Hyuk Yang, Dong-Gune Chang, Yunjin Nam, Seung Woo Suh Neurospine.2023; 20(3): 989. CrossRef
Screw Insertional Torque Measurement in Spine Surgery: Correlation With Bone Mineral Density and Hounsfield Unit Byeong Ho Oh, Jee Yong Kim, Jong Beom Lee, Jae Taek Hong, Jae Hoon Sung, Khoi D. Than, Ho Jin Lee, Il Sup Kim Neurospine.2023; 20(4): 1177. CrossRef
Objective To analyze differences in feasibility and efficacy between the paravertebral approach and microtubular tumorectomy (PAMT) or percutaneous transforaminal endoscopic tumorectomy (PTET) for the treatment of lumbar dumbbell-shaped tumors.
Methods Clinical data of dumbbell-shaped lumbar tumors in patients treated with PAMT or PTET in our hospital between June 2015 and November 2020 were retrospectively analyzed. The gross total resection (GTR) rate, operation time, estimated blood loss, postoperative hospital stay (PHS), postoperative neurological function, and spinal stability were compared between the 2 surgical methods. Neurological improvement was assessed using the pain visual analogue scale (VAS) and the Japanese Orthopaedic Association (JOA) score.
Results Fifteen cases of GTR (93.8%) and 1 case of subtotal resection were included in the PTET group, whilst all 18 patients in the PAMT group achieved GTR. There was no significant difference in the GTR rate, operation time, and PHS between the PAMT and PTET groups. The estimated blood loss was significantly lower in the PTET group than in the PAMT group. At the last follow-up, there was no significant difference in the VAS or JOA scores between PTET and PAMT. No tumor recurrence or spinal instability was observed in either group during the follow-up period.
Conclusion Both PAMT and PTET can achieve Eden type III-IV lumbar 1-stage tumor resection without additional spinal internal fixation due to reduced muscle, ligament, and facet joint damage. No lumbar instability and tumor recurrence occurred, and neurological function was improved.
Citations
Citations to this article as recorded by
Refining the far-lateral pathway: ten-year outcomes of posterolateral transforaminal resection of spinal tumors Caner Sarıkaya, Cumhur Kaan Yaltırık, Mustafa Umut Etli, Gonca Gül Öndüç, Jad Chokr, Evren Yüvrük, Mehmet Reşit Önen, Sait Naderi Journal of Neuro-Oncology.2026;[Epub] CrossRef
Intracapsular Resection of Thoracic Extradural Schwannomas via the Isthmic Approach: Investigation of Clinical Feasibility With 41 Case Series Wei Gao, Xinben Hu, Tianjian Liu, Aiqin Chen, Jingyin Chen, Chi Gu, Guangyu Ying, Qiangwei Wang, Yongjian Zhu CNS Neuroscience & Therapeutics.2025;[Epub] CrossRef
Comparison of the surgical outcomes of the posterior approach, video-assisted thoracic surgery, and combined approach for thoracic dumbbell tumors based on a new classification: a retrospective study Mao Zilong, Zhang Jinan, Li Weixin, Wang Peng, Zuo Wei Neurosurgical Review.2024;[Epub] CrossRef
Minimally invasive removal of dumbbell shaped schwannomas with transforaminal lumbar fusion: a retrospective study with a minimum 3-year follow-up V.A. Byvaltsev, A.A. Kalinin Burdenko's Journal of Neurosurgery.2024; 88(2): 47. CrossRef
Clinical Implications of Surgical Resection without Spinal Fixation in Lumbar Dumbbell Tumors: Evaluating Postoperative Lumbar Alignment and Patient Outcomes Toshiki Okubo, Narihito Nagoshi, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe World Neurosurgery.2024; 192: e547. CrossRef
Risk Factors of Restenosis After Full Endoscopic Foraminotomy for Lumbar Foraminal Stenosis: Case-Control Study Jong Hun Seo, Chang Il Ju, Seok Won Kim, Seung Myung Lee, Pius Kim Neurospine.2023; 20(3): 899. CrossRef
Feasibility and efficacy of spinal microtubular technique for resection of lumbar dumbbell-shaped tumors Rui Wang, Zeyan Liang, Yan Chen, Xiongjie Xu, Chunmei Chen Frontiers in Oncology.2022;[Epub] CrossRef
Minimally Invasive Facetectomy and Fusion for Resection of Extensive Dumbbell Tumors in the Lumbar Spine Michael Schwake, Emanuele Maragno, Marco Gallus, Stephanie Schipmann, Dorothee Spille, Bilal Al Barim, Walter Stummer, Michael Müther Medicina.2022; 58(11): 1613. CrossRef
Objective Midline lumbar interbody fusion is performed for treatment of various lumbar degenerative diseases, with good clinical outcomes and few complications. However, there are no large-scale or long-term studies regarding midline lumbar interbody fusion. Therefore, the purpose of this study was to evaluate the clinical results of midline lumbar interbody fusion and to compare the results according to surgical level.
Methods Between January 2013 and December 2015, 200 patients with lumbar degenerative disease undergoing midline lumbar interbody fusion surgery were enrolled. The mean patient age was 69.9 ± 15.8 years (range, 40–85 years). The patients were divided into groups according to surgical level: (1) level 1 operation (136 patients), (2) level 2 operation (43 patients), (3) level 3 operation (12 patients), and (4) level 4 or higher (9 patients). Clinical outcomes, fusion rates, and complications were compared among the 4 groups.
Results All clinical outcomes significantly improved after surgery (measured at 3 years postoperatively) in all groups. Mean fusion rate was 90.5% ± 5.21%. Fusion rate was highest in group I (95.8%) and lowest in group IV (85.2%). There were complications in 17 cases (8.5%). Adjacent segment disease occurred in 16 cases, 5 of which required surgery. Group 1 had 1 case, and group 4 had 4 cases. Screw loosening occurred in 1 case in group 4. There were no cases of infection or mechanical complications.
Conclusion This large, single‐institution, retrospective study demonstrates favorable clinical outcomes after midline lumbar interbody fusion for lumbar degenerative disease regardless of surgical level.
Citations
Citations to this article as recorded by
Open Midline Decompression with Ligament Reconstruction for Multiple-Level Spinal Stenosis in Elderly Patients Shin-Jae Kim, Sang-Ho Lee, Junseok Bae NeuroSci.2025; 6(1): 18. CrossRef
Surgical stabilization for degenerative lesions of the lumbar spine in patients with reduced bone mineral density: a systematic literature review I. V. Shirokikh, A. I. Vasilyev, Yu. M. Batrak, V. A. Peleganchuk Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika).2024; 21(1): 44. CrossRef
Postoperative urinary retention after oblique lumbar interbody fusion under the systematic management protocol Joonsoo Lim, Jangyeob Lim, Asfandyar Khan, Chang-Hyun Lee, Jun-Hoe Kim, Sejin Choi, Tae-Shin Kim, Yunhee Choi, Chun Kee Chung, Sangwook T. Yoon, Kyoung-Tae Kim, Chi Heon Kim Scientific Reports.2024;[Epub] CrossRef
Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients Chih-Chang Chang, Hsuan-Kan Chang, Chin-Chu Ko, Ching-Lan Wu, Yi-Hsuan Kuo, Tsung-Hsi Tu, Wen-Cheng Huang, Jau-Ching Wu Neurospine.2023; 20(1): 308. CrossRef
The Fusion Rate of Cortical Bone Trajectory Screw Fixation and Pedicle Screw Fixations in L4‐5 Interbody Fusion: A Retrospective Cohort Study Yuhe Lin, Jie Xu, Wu Zheng Orthopaedic Surgery.2023; 15(5): 1281. CrossRef
Minimally invasive fusion surgery for patients with degenerative spondylolisthesis and severe lumbar spinal stenosis: a comparative study between MIDLIF and TLIF Pedro Santos Silva, Ana Jardim, Joana Pereira, Rita Sousa, Rui Vaz, Paulo Pereira European Spine Journal.2023; 32(9): 3210. CrossRef
Cortical bone trajectory screws in the treatment of lumbar degenerative disc disease in patients with osteoporosis Song Guo, Kai Zhu, Mei-Jun Yan, Xin-Hua Li, Jun Tan World Journal of Clinical Cases.2022; 10(36): 13179. CrossRef
Cervicothoracic deformity correction often necessitates a shortening operation, consisting of a 3-column osteotomy (3CO). While effective, segmental compression and in situ and cantilever bending often place screws under considerable stress and may jeopardize deformity correction. In this report, we present the surgical technique of a novel method, the “rail technique,” to shorten across a vertebral column resection (VCR) for cervicothoracic deformity correction. A 65-year-old woman with a history of a C5-pelvis posterior instrumented fusion (PSIF) presented with chin-on-chest deformity after a prior proximal junctional failure/kyphosis at T4 (30° T3–5) above a prior T5-pelvis PSIF that was stabilized in situ. She underwent an uncomplicated revision C2–T10 PSIF with shortening across a T4 VCR using the “rail technique.” Postoperatively, radiographs demonstrated excellent restoration of and normalization of cervical sagittal alignment, thoracic kyphosis, focal T3–5 kyphosis (7°), and global sagittal alignment. At 1-year postoperation, she was without neck pain and reported significant improvements in self-image, mental health, satisfaction, and subscale Scoliosis Research Society-22 scores compared to preoperative values. The “rail technique” is a safe and effective method for shortening over a 3CO to correct the cervicothoracic deformity.
Citations
Citations to this article as recorded by
Closing a Three-Column Osteotomy with a Construct-To-Construct Closure: Case Series and Technical Note With Intraoperative Pictures and Videos Harsh Jain, Ranbir Ahluwalia, Iyan Younus, Tyler Zeoli, Keyan Peterson, Zeeshan M. Sardar, Scott L. Zuckerman Operative Neurosurgery.2026; 30(2): 289. CrossRef
Construct–construct “rail technique” decreases screw strain during spinal deformity corrective maneuvers across a thoracic vertebral column resection: a cadaveric analysis Alekos A. Theologis, Jason DePhillips, Izabella T. Lachcik, Jonathan M. Mahoney, Brandon S. Bucklen Spine Deformity.2026; 14(1): 39. CrossRef
Construct-construct “rail technique” decreases screw strain during spinal deformity corrective maneuvers: a mechanical analysis Alekos A. Theologis, Jason DePhillips, Nathaniel A. Myers, Jonathan M. Mahoney, Brandon S. Bucklen Spine Deformity.2025; 13(4): 987. CrossRef
Commentary: Proximal Junctional Fracture and Kyphosis: Correction With Posterior Vertebral Column Resection and the “Rail Technique”: 2-Dimensional Operative Video Iyan Younus, Hani Chanbour, Scott L. Zuckerman Operative Neurosurgery.2024; 26(2): 238. CrossRef
Progressive coronal caudal curve after corrective osteotomies for congenital cervicothoracic scoliosis: incidence and predictors Ziqun Liu, Bin Jiang, Yifang Jiang, Yawei Li, Yuliang Dai, Lei Li, Yupeng Zhang, Zhenzhong Zheng, Bing Wang European Spine Journal.2024; 33(4): 1675. CrossRef
Case Report: Does the misplaced titanium mesh cage after total spondylectomy causing cervicothoracic cord compression need to be removed during revision surgery? Xin Wang, XiaoFei Cheng, Jie Zhao, ChangQing Zhao Frontiers in Surgery.2024;[Epub] CrossRef
For all the spine surgeons, thoracic disc herniations (TDHs) entrust a real challenge in terms of patient diagnosis, proper selection, surgical technique, and potential adverse events. TDHs are relatively uncommon compared to the lumbar and cervical levels. Literature reports a variable prevalence of TDHs around 6% to 40%, but less than 1% of all disk herniations are symptomatic TDHs, evidencing as a relatively unusual condition. Nowadays, transforaminal endoscopic thoracic discectomy (TETD) has been implemented as an alternative to classic open procedures with results that are as good as and, in some situations, better than those in traditional discectomy. However, the surgeon must be familiar with endoscopic lumbar spine surgery before opting to perform a TETD, considering that the learning curve is much harder. We describe all the steps and safety considerations during TETD based on the anatomic differences compared to lumbar endoscopic procedures. TETD is an effective and safe method that yields more benefits, provides a direct route to the lesion with less morbidity, and is performed in a minimally invasive way. Many severe complications related to the thoracic region could be avoided having the proper knowledge, adequate technique, and safety routes and considerations.
Citations
Citations to this article as recorded by
Case Report: A Brodie's abscess in the spine in a female patient treated by percutaneous endoscopic debridement and drainage Tsung-Lin Yang, Chen-Pang Huang, Hung-Kang Wu, Yu-Pao Hsu, Ching-Hsiao Yu Frontiers in Surgery.2026;[Epub] CrossRef
Uniportal Endoscopic Surgery for Thoracolumbar Junction Disc Herniation in a Patient With Myelopathy: A Technical Note and Surgical Video Kang Suk Moon, Michel Gustavo Mondragón-Soto, Pedro Leonardo Villanueva-Solórzano Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 155. CrossRef
Unilateral Biportal Endoscopic Transforaminal Approach for Chronic Central Thoracic Disc Herniation: A Video Case Report and Surgical Technique Description Kwan-Su Song, Pius Kim Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 144. CrossRef
Full-endoscopic resection of a thoracic facet joint osteoblastoma: A case report Mohammad Badra, Hafez Saade, Fouad Assaf, Ramzi Moucharafieh, Youssef Jamaleddine Brain and Spine.2026; 6: 106151. CrossRef
Open Versus Endoscopic Approach for Thoracic Disk Herniations: Equivalent Short-Term Outcomes With Significantly Different Costs Campbell Liles, Hani Chanbour, Omar Zakieh, Keyan Peterson, Robert J. Dambrino, Iyan Younus, Soren Jonzzon, Richard A. Berkman, Julian G. Lugo-Pico, Amir M. Abtahi, Byron F. Stephens, Scott L. Zuckerman, Raymond J. Gardocki Operative Neurosurgery.2025; 28(3): 347. CrossRef
Advancements in Spinal Endoscopic Surgery: Comprehensive Techniques and Pathologies Addressed by Full Endoscopy Beyond Lumbar Disc Herniation Jad El Choueiri, Francesca Pellicanò, Edoardo Caimi, Francesco Laurelli, Leonardo Di Cosmo, Ali Darwiche Rada, Daniel Cernigoi, Arosh S. Perera Molligoda Arachchige, Giorgio Cracchiolo, Donato Creatura, Ali Baram, Carlo Brembilla, Gabriele Capo Journal of Clinical Medicine.2025; 14(11): 3685. CrossRef
Rediscovering Posterior Cervical Foraminotomy/Diskectomy With the Endoscope: A Favorable Cost Comparison with the Traditional Treatment of a Cervical Radiculopathy Campbell Liles, Hani Chanbour, Alexander T. Lyons, Emma Ye, Omar Zakieh, Robert J. Dambrino, Iyan Younus, Soren Jonzzon, Richard A. Berkman, Julian G. Lugo-Pico, Amir M. Abtahi, Byron F. Stephens, Scott L. Zuckerman, Raymond J. Gardocki Operative Neurosurgery.2025;[Epub] CrossRef
Thoracic spine endoscopic techniques Jian Shen, Daniel K. Park, Albert E. Telfeian Seminars in Spine Surgery.2024; 36(1): 101085. CrossRef
Spinal endoscopy - treatment of the lumbar disc herniation Peter Hudák, Jakub Šipoš, Kristián Varga, Ján Kozák, Martin Sedliak, Benedikt Trnovec, Milan Liška Neurologie pro praxi.2024; 25(5): 383. CrossRef
Complications and Management of Endoscopic Spinal Surgery Chang Il Ju, Seung Myung Lee Neurospine.2023; 20(1): 56. CrossRef
Uniportal, Transforaminal Endoscopic Thoracic Discectomy: Review and Technical Note Sang Hun Lee, Farah N. Musharbash Neurospine.2023; 20(1): 19. CrossRef
Cost-utility analysis of endoscopic lumbar discectomy following a uniform clinical pathway in the Korean national health insurance system Chi Heon Kim, Yunhee Choi, Chun Kee Chung, Seung Heon Yang, Chang-Hyun Lee, Sung Bae Park, Keewon Kim, Sun Gun Chung, Sathish Muthu PLOS ONE.2023; 18(6): e0287092. CrossRef
Mikroszkópos és endoszkópos vizualizációval végzett, minimálisan invazív dekompressziós gerincműtétekkel kapcsolatos tapasztalataink Márton Balázsfi, Norbert Szappanos, Gergely Lehelvári, Dávid Kis, Pál Barzó Orvosi Hetilap.2023; 164(49): 1926. CrossRef
Foundations in Spinal Endoscopy Ibrahim Hussain, Michael L.J. Apuzzo, Michael Y. Wang World Neurosurgery.2022; 160: 125. CrossRef
Full Endoscopic Surgery for Thoracic Pathology: Next Step after Mastering Lumbar and Cervical Endoscopic Spine Surgery? Junseok Bae, Sang-Ho Lee, Ralf Wagner, Jian Shen, Albert E. Telfeian, Kai Uwe Lewandrowski BioMed Research International.2022;[Epub] CrossRef
Current Status and research hotspots in the field of full endoscopic spine surgery: A bibliometric analysis Guang-Xun Lin, Ming-Tao Zhu, Vit Kotheeranurak, Pengfei Lyu, Chien-Min Chen, Bao-Shan Hu Frontiers in Surgery.2022;[Epub] CrossRef
Global Trends and Hotspots in Endoscopic Discectomy: A Study Based on Bibliometric Analysis Boyu Wu, Lei Yang, Chengwei Fu, Yue Zhuo, Xiang Feng, Hui Xiong Neurospine.2022; 19(4): 1093. CrossRef
Full endoscopic surgery for thoracic pathology: an assessment of supportive evidence Rory D. S. Gibson, Ralf Wagner, J. N. Alastair Gibson EFORT Open Reviews.2021; 6(1): 50. CrossRef
Expanded Indications of Full Endoscopic Spine Sugery Ajay Krishnan, Hyeun Sung Kim, Aditya Raj, Bharat R Dave Journal of Minimally Invasive Spine Surgery and Technique.2021; 6(Suppl 1): S130. CrossRef
The cause of radiculopathy is the compression of the nerve root which can be secondary to sliding of the vertebra and reduced disc height. In some patients, decompression alone does not resolve this problem. We describe the uniportal endoscopic transforaminal lumbar interbody fusion technique. Full-endocopic foraminotomy and discectomy are followed by cage implementation and percutaneous instrumentation. The goal of this surgical method is decompression of nerve roots, segment stabilization, disc height, and sagittal alignment restoration. Uniportal endoscopic facet sparing transforaminal transkambin lumbar interbody fusion is a good surgical option to treat degenerative disc disease, mechanical instability, and spondylolisthesis. This method shows favourable clinical outcomes in selected patients.
Citations
Citations to this article as recorded by
Cage design-centric glider approach to full-endoscopic lumbar fusion: optimizing nerve root protection in facet-sparing and facet-resecting techniques Yu-Chia Hsu, Hao-Chun Chuang, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Hyeun-Sung Kim, Cheng-Li Lin Asian Spine Journal.2026; 20(2): 343. CrossRef
Robotic-Assisted Uniportal Full-Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Note on a Hybrid Form of Minimally Invasive Surgery Ting Yao Ang, A. Aravin Kumar, Chin Hong Ngai, John J.Y. Zhang, Jacob Y.L. Oh, Ji Min Ling, Thomas C.H. Tan Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(1): 105. CrossRef
Clinical and Radiological Outcomes of Double-Cage Full Endoscopic Transforaminal Lumbar Interbody Fusion Compared with Posterior Lumbar Interbody Fusion : A Retrospective Cohort Study Chi Ho Kim, Pius Kim, Chang Il Ju, Jong Hun Seo Journal of Korean Neurosurgical Society.2026; 69(4): 596. CrossRef
Extramedullary Spinal Tumor Excision With the Unilateral Biportal Endoscopic Spine Surgery Technique Shao-Keh Hsu, Lunghsing Lee Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(Suppl 1): S89. CrossRef
Open Midline Decompression with Ligament Reconstruction for Multiple-Level Spinal Stenosis in Elderly Patients Shin-Jae Kim, Sang-Ho Lee, Junseok Bae NeuroSci.2025; 6(1): 18. CrossRef
Totally endoscopic trans‑superior articular process lumbar interbody fusion: A case series on the development and preliminary evaluation of an innovative minimally invasive lumbar spine surgical technique Hualv Liu, Junjie Li, Yuhao Gao, Shilei Qin, Pengfei Han, Yunfeng Xu Experimental and Therapeutic Medicine.2025; 30(1): 1. CrossRef
Effects of two endoscopic posterior lumbar interbody fusion surgical sequences for treatment of unstable lumbar spinal stenosis: a retrospective study Hengyan Pan, Ruibing Feng, Xiaofeng Duan, Yizheng Huang, Hao Hu, Gang Wu, Yong Huang Frontiers in Surgery.2025;[Epub] CrossRef
Unilateral Biportal Endoscopy or Minimally Invasive Surgery for Transforaminal Lumbar Interbody Fusion? A Comparative Cohort Study Yansheng Huang, Zhen Chang, Sibo Wang, Baorong He World Neurosurgery.2025; 204: 124543. CrossRef
The Learning Curve of Endoscopic Lumbar Interbody Fusion: A Systematic Review Yong Ahn, Hajin An, Sol Lee, Hee Seon Choi, Hye Soo Rho Journal of Clinical Medicine.2025; 14(24): 8926. CrossRef
Comparative Analysis of Uniportal and Biportal Endoscopic Transforaminal Lumbar Interbody Fusion in Early Learning Stage: Technical Considerations and Radiological Outcomes Ji Yeon Kim, Hyun Jin Hong, Hyeun Sung Kim, Dong Hwa Heo, Su Yong Choi, Kyoung Mo Kim, Dong Chan Lee, Choon Keun Park Journal of Minimally Invasive Spine Surgery and Technique.2024; 9(Suppl 1): S14. CrossRef
Evolution of the Transforaminal Lumbar Interbody Fusion (TLIF): From Open to Percutaneous to Patient-Specific Peter N. Drossopoulos, Favour C. Ononogbu-uche, Troy Q. Tabarestani, Chuan-Ching Huang, Mounica Paturu, Anas Bardeesi, Wilson Z. Ray, Christopher I. Shaffrey, C. Rory Goodwin, Melissa Erickson, John H. Chi, Muhammad M. Abd-El-Barr Journal of Clinical Medicine.2024; 13(8): 2271. CrossRef
Optimizing Disc and Cartilage Endplate Preparation in Full-Endoscopic Lumbar Interbody Fusion: An In-Depth Exploration of Surgical Instruments with a Technique Note and Narrative Review Kai-Ting Chien, Hsiang-Wei Feng, Ting-Kuo Chang, Yueh-Ching Liu, Lei-Po Chen, Yu-Ching Huang, Yan-Shiang Lian, Jian-You Li World Neurosurgery.2024; 189: 228. CrossRef
Full-Endoscopic Posterior Lumbar Interbody Fusion: A Review and Technical Note Yasuhiro Nakajima, Akira Dezawa, Kang-Teak Lim, Pang Hung Wu World Neurosurgery.2024; 189: 418. CrossRef
How to Prevent Nerve Root Injury in Uniportal Full Endoscopic Lumbar Fusion Surgery? Insights From a Cadaveric Anatomic Study With Simulation Surgery Yu-Chia Hsu, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Hyeun-Sung Kim, Cheng-Li Lin Spine.2024; 49(18): 1301. CrossRef
Full-endoscopic lumbar spine surgery using working-channel endoscopes: technical tips for practical effectiveness Yong Ahn Expert Review of Medical Devices.2024; 21(12): 1131. CrossRef
Comparison of efficacy and safety between unilateral biportal endoscopic transforaminal lumbar interbody fusion versus uniportal endoscopic transforaminal lumbar interbody fusion for the treatment of lumbar degenerative diseases: a systematic review and m Yi Ding, Hao Chen, Gang Wu, Tao Xie, Liulong Zhu, Xuepeng Wang BMC Musculoskeletal Disorders.2024;[Epub] CrossRef
Reducing Postoperative Neurological Complications in Uniportal Full-Endoscopic Lumbar Interbody Fusion: Efficacy of the GUARD Technique Combined With Delayed Ligamentum Flavectomy Hao-Chun Chuang, Yu-Chia Hsu, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Hyeun Sung Kim, Cheng-Li Lin Neurospine.2024; 21(4): 1199. CrossRef
Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique Yu-Chia Hsu, Hao-Chun Chuang, Wei-Lun Chang, Yuan-Fu Liu, Chao-Jui Chang, Yu-Meng Hsiao, Yi-Hung Huang, Keng-Chang Liu, Chien-Min Chen, Hyeun-Sung Kim, Cheng-Li Lin Neurospine.2024; 21(4): 1141. CrossRef
Transforaminal Endoscopic Approach to L5S1: Imaging Characterization of the Lower Lumbar Spine and Pelvis for Surgical Planning José Miguel Sousa, António Serrano, Afonso Nave, Vasco Mascarenhas, Paulo Nogueira, Joao Gamelas, José Guimarães Consciência World Neurosurgery.2023; 175: e809. CrossRef
Minimally invasive transforaminal lumbar interbody fusion by a novel two-medium compatible bichannel endoscopy system, technique note and preliminary clinical results Haoyu Gong, Yunshan Fan, Yingchuan Zhao, Fangjing Chen, Jia Chen, Huang Yan, Guangfei Gu, Chuanfeng Wang, Haijian Ni, Shisheng He European Spine Journal.2023; 32(8): 2845. CrossRef
Cost-utility analysis of endoscopic lumbar discectomy following a uniform clinical pathway in the Korean national health insurance system Chi Heon Kim, Yunhee Choi, Chun Kee Chung, Seung Heon Yang, Chang-Hyun Lee, Sung Bae Park, Keewon Kim, Sun Gun Chung, Sathish Muthu PLOS ONE.2023; 18(6): e0287092. CrossRef
TRANSILIAC ENDOSCOPIC ASSISTED ILIF: A CADAVERIC STUDY Jose Miguel Sousa, Hugo Ribeiro, João Gamelas, Jose Guimarães Consciencia Coluna/Columna.2023;[Epub] CrossRef
“Early Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion Versus Minimal Invasive in the Treatment of Lumbar Degenerative Diseases” Qi Yu, Xuqi Hu, Xuekang Pan, Xiangjia Kong, Jianqiao Zhang, Yefeng Yu, Jiayi Chen, Peng Ren, Huigen Lu Clinical Spine Surgery.2023; 36(8): E390. CrossRef
Transiliac Endoscopic-Assisted L5S1 Intraforaminal Lumbar Interbody Fusion: Technical Considerations and Potential Complications José Miguel Sousa, João Luís Silva, João Gamelas, José Guimarães Consciência World Neurosurgery.2023; 178: e741. CrossRef
Future of Endoscopic Spine Surgery: Insights from Cutting-Edge Technology in the Industrial Field Woon-Tak Yuh, You-Sang Lee, Il Choi Bioengineering.2023; 10(12): 1363. CrossRef
Mikroszkópos és endoszkópos vizualizációval végzett, minimálisan invazív dekompressziós gerincműtétekkel kapcsolatos tapasztalataink Márton Balázsfi, Norbert Szappanos, Gergely Lehelvári, Dávid Kis, Pál Barzó Orvosi Hetilap.2023; 164(49): 1926. CrossRef
Clinical outcomes, complications and fusion rates in endoscopic assisted intraforaminal lumbar interbody fusion (iLIF) versus minimally invasive transforaminal lumbar interbody fusion (MI-TLIF): systematic review and meta-analysis José Miguel Sousa, Hugo Ribeiro, João Luís Silva, Paulo Nogueira, José Guimarães Consciência Scientific Reports.2022;[Epub] CrossRef
Endoscopic Techniques for Lumbar Interbody Fusion: Principles and Context Bryan Zheng, Elias Shaaya, Josh Feler, Owen P. Leary, Matthew J. Hagan, Ankush Bajaj, Jared S. Fridley, Frank Hassel, Raymond Gardocki, Ricardo Casal Grau, Kai-Uwe Lewandrowski, Albert E. Telfeian, Fu-Ming Tsai BioMed Research International.2022;[Epub] CrossRef
Radiation Dose Reduction and Surgical Efficiency Improvement in Endoscopic Transforaminal Lumbar Interbody Fusion Assisted by Intraoperative O-arm Navigation: A Retrospective Observational Study Junfeng Gong, Xinle Huang, Liwen Luo, Huan Liu, Hao Wu, Ying Tan, Changqing Li, Yu Tang, Yue Zhou Neurospine.2022; 19(2): 376. CrossRef
CLINICAL RESULTS OF EVOLUTIONAL CHANGE OF PRACTICE FROM OPEN TO ENDOSCOPIC SURGERY FOR CERVICAL DISC HERNIATION AND FORAMINAL STENOSIS Hyeun Sung Kim, Pang Hung Wu, Ji Yeon Kim, Yeon Jin Lee, Jun Hyung Lee, Jun Bok Jeon, Il-Tae Jang Journal of Musculoskeletal Research.2022;[Epub] CrossRef
Full-Endoscopic versus Minimally Invasive Lumbar Interbody Fusion for Lumbar Degenerative Diseases : A Systematic Review and Meta-Analysis Seong Son, Byung Rhae Yoo, Sang Gu Lee, Woo Kyung Kim, Jong Myung Jung Journal of Korean Neurosurgical Society.2022; 65(4): 539. CrossRef
Current Status and research hotspots in the field of full endoscopic spine surgery: A bibliometric analysis Guang-Xun Lin, Ming-Tao Zhu, Vit Kotheeranurak, Pengfei Lyu, Chien-Min Chen, Bao-Shan Hu Frontiers in Surgery.2022;[Epub] CrossRef
Commentary on “Endoscopic Transforaminal Lumbar Interbody Fusion – Technical note” Junseok Bae Journal of Spinal Surgery.2022; 9(4): 240. CrossRef
Clinical Results and Complications of Endoscopic Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Meta-Analysis Dong Hwa Heo, Dong Chan Lee, Hyeun Sung Kim, Choon Keun Park, Hungtae Chung World Neurosurgery.2021; 145: 396. CrossRef
Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note Hyeun-Sung Kim, Pang-Hung Wu, Jin-Woo An, Yeon-Jin Lee, Jun-Hyung Lee, Myeong-Hun Kim, Inkyung Lee, Jong-Sung Park, Jun-Hyung Lee, Jun-Hwan Park, Il-Tae Jang Brain Sciences.2021; 11(9): 1169. CrossRef
Transforaminal endoscopic lumbar discectomy (TELD) with the outside-in technique can be applied to nearly all cases of lumbar disc herniation (LDH), and transpedicular endoscopic lumbar discectomy can be used to treat highly migrated LDHs. The purpose of this study was to outline these 2 outside-in surgical techniques and to present their clinical outcomes. Between January 2018 and January 2019, a total of 137 patients underwent either transforaminal or transpedicular endoscopic lumbar discectomy. We performed TELD in 124 patients and transpedicular endoscopic lumbar discectomy in 13 cases. All surgical procedures were performed under conscious sedation. The patients’ mean age was 51.3 years; 51 were women and 86 were men. The overall disc recurrence rate was 5.12%. Visual analogue scale scores decreased significantly in both groups. According to the MacNab criteria, good and excellent results were obtained in 92.74% of patients after transforaminal and in 92.30% of patients after transpedicular endoscopic LDH treatment. The results suggest that TELD with the outside-in technique can be effective for the treatment of most cases of LDH. Transpedicular endoscopic lumbar discectomy can be considered as an alternative treatment for highly migrated LDH.
Citations
Citations to this article as recorded by
Learning curve in full-endoscopic lumbar surgery for disc herniation in a spine clinic in Mexico: Comparative analysis of IELD and TELD techniques Jose-Carlos Sauri-Barraza, Luis Enrique Nuñez-Alvarado, Eduardo Callejas-Ponce, Jorge Daniel Perez-Ruiz, Eugenio Carral-Robles-Leon, Carlo Enrico Bañuelos-Aluzzi, Luis Manuel Solis-Reyna, Jesus Ernesto Valdez-Aguilar, Francisco Garcia-Muñoz Brain and Spine.2026; 6: 106132. CrossRef
Large-Channel Interlaminar Endoscopic Discectomy for Highly Migrated Lumbar Disc Herniation: Effectiveness and Safety Shicheng Zheng, Qinghua Zhao, Zongshan Hu, Haibo Li, Bin Wang, Zezhang Zhu, Yong Qiu, Xu Sun Journal of Pain Research.2025; Volume 18: 3821. CrossRef
Full-endoscopic discectomy for thoracic disc herniations: a single-arm meta-analysis of safety and efficacy outcomes Jackson Daniel Sousa Silva, Luis E. Carelli, José A. A. de Oliveira, Ricardo M. L. de Araújo European Spine Journal.2023; 32(4): 1254. CrossRef
Full Endoscopic Translaminar Approach Using 7 mm Working Endoscope for High Up Migrated Disc Herniation with Severely Collapsed Disc Space: Technical Note Harshavardhan Dilip Raorane, Hyeun-Sung Kim, Rishi doshi, Kiran doshi Journal of Minimally Invasive Spine Surgery and Technique.2023; 8(1): 120. CrossRef
Narrative Review of Pathophysiology and Endoscopic Management of Basivertebral and Sinuvertebral Neuropathy for Chronic Back Pain Hyeun Sung Kim, Pang Hung Wu, Il-Tae Jang Journal of Korean Neurosurgical Society.2023; 66(4): 344. CrossRef
Biomechanical Study of Minimally Invasive Nonfusion Surgery for Treatment of Disc Herniation Associated with Adjacent Segment Disease: A Finite Element Analysis Kai-Hua Li, Zhi-Guo Li, Hui-Ling Xiong, Xiao-Ning Liu, Xin-Long Ma World Neurosurgery.2023; 179: e305. CrossRef
Percutaneous Radiofrequency Disc Decompression: A Study of 27 Patients N Živković, S Ruetten, G Tasić, A Janicijević, K Jelena, J Nikola, I Andjelković, S Jovanović Nigerian Journal of Clinical Practice.2023; 26(12): 1850. CrossRef
Retrospective Study of Minimal Three-Year Follow-Up of Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation: 5000 Multicenter Cases Chuanchao Du, Kunfeng Song, Bao Hai, Xiangyu Wang Cureus.2023;[Epub] CrossRef
Targeted fully endoscopic visualized laminar trepanning approach under local anaesthesia for resection of highly migrated lumbar disc herniation Chao Chen, Xun Sun, Jie Liu, Xinlong Ma, Dong Zhao, Haiyun Yang, Gang Liu, Baoshan Xu, Zheng Wang, Qiang Yang International Orthopaedics.2022; 46(7): 1627. CrossRef
Full Endoscopic Surgery for Thoracic Pathology: Next Step after Mastering Lumbar and Cervical Endoscopic Spine Surgery? Junseok Bae, Sang-Ho Lee, Ralf Wagner, Jian Shen, Albert E. Telfeian, Kai Uwe Lewandrowski BioMed Research International.2022;[Epub] CrossRef
Objective Percutaneous cervical nucleoplasty (PCN) is used to treat cervical disc herniation. Radiological imaging studies, including plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI), have been used to make early predictions of cervical spinal surgery outcomes. However, simple radiological studies do not provide sufficiently detailed information; moreover, CT and MRI are highly expensive. Herein, we aimed to elucidate the usefulness of digital infrared thermography imaging (DITI) as an outcome marker after cervical nucleoplasty by correlating the changes in thermal difference (ΔTD) with the changes in pain intensity after PCN expressed as visual analogue scale (ΔVAS) scores.
Methods For this study, 255 patients treated with PCN at Thomas Hospital between March 2012 and August 2014 were included. For each patient, demographic and clinical data, including preoperative MRI results, ΔVAS, ΔTD at the disc level treated with PCN, subjective symptom improvement, procedure-related discomfort, overall satisfaction, and adverse effects, were collected and evaluated for up to 3 months retrospectively.
Results Thermal difference (TD) and VAS scores improved after PCN (p<0.05), but ΔTD showed no significant correlation with ΔVAS. If the preoperative TD was larger, the postoperative VAS was worse and there was less pain relief (ΔVAS) after PCN (p<0.05). Only few adverse effects were noticeable after PCN.
Conclusion In DITI, which was used to evaluate the outcomes after cervical nucleoplasty, the ΔTD did not seem to reflect the ΔVAS after PCN. However, preoperative DITI findings could be useful for predicting VAS reduction and clinical improvements after PCN.
Citations
Citations to this article as recorded by
Phenotypic Classification of Low Back Pain in Rheumatic and Spinal Disorders: A Data-Driven Approach Using Latent Tree Analysis Minh Quan Le Hoang, Dieu Dang Thi, Ngoc Nghia Nguyen Thi, Thuong Hoai Nguyen, Bao Ngoc Le, Thuc Anh Ho, My Phuong Nguyen Thi Journal of Integrative and Complementary Medicine.2026;[Epub] CrossRef
Research Progress on Low-Temperature Plasma Nucleoplasty and Targeted Radiofrequency for Cervical Spondylotic Radiculopathy: A Retrospective Review Jiajia Deng, Chenxuan Xiao, Keyue Xie Pain and Therapy.2026;[Epub] CrossRef
Research Progress in the Application of In-frared Thermal Imaging Technology in the Treatment of Spinal Pain 言 庄 Advances in Clinical Medicine.2023; 13(08): 12876. CrossRef
Letter to the Editor: Commentary on Comparison of the Clinical Effectiveness Between Infrared Thermography and Electrophysiology Tests in Spinal Intradural Extramedullary Schwannoma (Korean J Neurotrauma 2022;18:e38) Suk-Hyung Kang Korean Journal of Neurotrauma.2022; 18(2): 314. CrossRef
A New Role for Epidurography: A Simple Method for Assessing the Adequacy of Decompression during Percutaneous Plasma Disc Decompression Ho Young Gil, Wonseok Seo, Gyu Bin Choi, Eunji Ha, Taekwang Kim, Jungyul Ryu, Jae Hyung Kim, Jong Bum Choi Journal of Clinical Medicine.2022; 11(23): 7144. CrossRef
Advances in infrared thermography: Surgical aspects, vascular changes, and pain monitoring in veterinary medicine Alejandro Casas-Alvarado, Daniel Mota-Rojas, Ismael Hernández-Ávalos, Patricia Mora-Medina, Adriana Olmos-Hernández, Antonio Verduzco-Mendoza, Brenda Reyes-Sotelo, Julio Martínez-Burnes Journal of Thermal Biology.2020; 92: 102664. CrossRef
First
Prev
