Table of Contents
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PREFACE
List of Contributors
Cervical Endoscopy: Historical Perspectives, Present & Future
Abstract
INTRODUCTION
RECYCLED TRENDS
THE CERVICAL ENDOSCOPE OF THE FUTURE
THE OBJECTIVE
THE ADOPTION & TRAINING DILEMMA
THE PARADIGM SHIFT
THE BENEFITS
THE ACCEPTANCE LAG
THE HISTORY
LASERS
RADIOFREQUENCY
NEW LANDMARK CLINICAL OUTCOME STUDIES
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anesthesia for Minimally Invasive Surgery of the Cervical Spine
Abstract
INTRODUCTION
ANESTHESIA STRATEGIES
SEDATION
ANESTHESIA FOR CERVICAL ENDOSCOPY IN AMBULATORY SURGERY CENTER (ASC)
SEDATIVES
Benzodiazepines
Propofol
Dexmedetomidine
Remifentanil
Ketamine
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Algorithms to Choose Between Anterior and Posterior Cervical Endoscopy
Abstract
INTRODUCTION
HERNIATED DISC
ALGORITHM FOR HERNIATED DISC
ALGORITHM FOR FORAMINAL STENOSIS
ALGORITHM FOR CENTRAL CERVICAL STENOSIS
THE IMPACT OF TECHNOLOGY ADVANCES
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Contemporary Clinical Decision Making in Full Endoscopic Cervical Spine Surgery
Abstract
INTRODUCTION
CLINICAL AND RADIOGRAPHIC EVALUATION
MAGNETIC RESONANCE IMAGING
ANATOMIC CONSIDERATION
Anterior Approach
Prevertebral Structures
Carotid Artery Bifurcation
Posterior Approach
Length of the Exposed Nerve Root
Bone Resection
Relation Between Nerve Root & Disc
CLASSIFICATION SYSTEMS FOR SURGICAL DECISION MAKING
Classification of Cervical Foraminal Stenosis
Classification of Cervical Canal Stenosis
Classification of Cervical Disc Herniations
Cervical Myelopathy Classification
CLINICAL DECISION MAKING
For Herniated Disc
For Stenosis
THE SURGEON FACTOR & HOW TO ARRIVE AT THE PREFERRED PROCEDURE
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Indications and Outcomes with Endoscopic Posterior Cervical Rhizotomy
Abstract
INTRODUCTION
SURGICAL TECHNIQUE
CLINICAL SERIES
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anterior Endoscopic Cervical Discectomy
Abstract
INTRODUCTION
ANATOMICAL CONSIDERATIONS
ENDOSCOPIC INSTRUMENTATION
POSITIONING & SETUP
PEARLS OF SETUP & ACCESS
TWO FINGER MOBILIZATION & NEEDLE PLACEMENT
ENDOSCOPIC SURGERY PEARLS
POSTOPERATIVE MANAGEMENT
CLINICAL SERIES
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anterior Transcorporeal Approach of Percutaneous Endoscopic Cervical Discectomy
Abstract
INTRODUCTION
SURGICAL TECHNIQUE
CLINICAL SERIES
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anterior Endoscopic Cervical Discectomy and Foraminoplasty for Herniated Disc and Lateral Canal Stenosis
Abstract
INTRODUCTION
BACKGROUND
OBJECTIVE
ANTERIOR ENDOSCOPIC CERVICAL FORAMINOPLASTY
Indications
Contraindications
Patient Positioning & Anesthesia
Equipment & Instrumentation
SURGICAL TECHNIQUE
LEARNING CURVE
CLINICAL OUTCOMES
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Posterior Full Endoscopic Cervical Discectomy & Foraminotomy
Abstract
INTRODUCTION
CLINICAL PRESENTATION
ADVANTAGES OF ENDOSCOPICALLY VISUALIZED POSTERIOR FORAMINOTOMY
INDICATIONS & CONTRAINDICATIONS
POSITIONING & ANESTHESIA
OR SETUP
SURGICAL TECHNIQUE
The Trans-“V-point” Foraminotomy Technique
Posterior Cervical Disectomy with Neural Retraction
CLINICAL SERIES
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Posterior Endoscopic Decompression for Cervical Spondylotic Myelopathy
Abstract
INTRODUCTION
CLINICAL SERIES
ENDOSCOPIC SURGICAL TECHNIQUE
POSTOPERATIVE REHABILITATION
EXEMPLARY CASES
CLINICAL OUTCOMES
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Full Endoscopic Partial Pediculotomy, Partial Vertebrotomy Technique For Cervical Degenerative Spinal Disease
Abstract
INTRODUCTION
RATIONALE
Anatomical Relationship of Cervical Disc, Pedicle & Exiting Nerve Root
Current Limitation of Posterior Endoscopic Cervical Foraminotomy and Discectomy
Concept of Subneural Space Creation for Endoscopic Instruments
Concepts of Creation of Sub-Corporeal Space
Preoperative Evaluation
Anesthesia and Positioning
SURGICAL STEPS
Identification of Level and Safe Docking of the Endoscope
Superficial Soft Tissue Dissection & Bone Drilling
Deep Bony Dissection
Partial Pediculotomy
Exposure of Neural Elements
Decompression of Uncovertebral Joint in Cases of Foraminal Stenosis
Partial Vertebrotomy (Optional)
Discectomy
Hemostasis & Closure
POTENTIAL RISKS
POSTOPERATIVE AND REHABILITATION PROTOCOL
CLINICAL SERIES
DISCUSSION
TECHNICAL PEARLS
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Full Endoscopic Anterior Cervical Decompression & Fusion With Iliac Crest Dowel Graft
Abstract
INTRODUCTION
HISTORICAL CONSIDERATIONS
THE OBJECTIVE
SURGICAL CONCEPTS
PROCEDURTAL STEPS
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Percutaneous Endoscopically Assisted Cervical Facet Reduction
Abstract
INTRODUCTION
AN EXEMPLARY CASE
ENDOSCOPIC DECOMPRESSION & REDUCTION
DEFINITIVE STABILIZATION
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Endoscopically Assisted Minimally Invasive Laminoplasty in The Treatment of Cervical Spondylotic Myelopathy
Abstract
INTRODUCTION
CASE INTRODUCTION
INDICATION FOR SURGERY & TECHNIQUE
CLINICAL COURSE
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
A Case Series Report of Endoscopic Debridement and Placement of an Intralesional Catheter for Chemotherapy of Cervical Tuberculosis
Abstract
INTRODUCTION
CASE 1
CASE 2
CASE 3
DISCUSSION
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Cervical Endoscopic Spinal Surgery: Sequela, Failure to Cure, Complications and Their Management
Abstract
INTROCUTION
THE REFERENCES STANDARDS
ACCESS & WOUND PROBLEMS
SEQUALAE
RECURRENT LARYNGEAL NERVE
DURAL LEAK
INCOMPLETE DECOMPRESSION & FAILURE TO CURE
VASCULAR INJURY
SPINAL CORD INJURY
CONCLUSIONS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Contemporary Endoscopic Spine Surgery
(Volume 1)
Cervical Spine
Edited by
Kai-Uwe Lewandrowski
Center For Advanced Spine Care
Tucson
Arizona
USA
Jorge Felipe Ramírez León
Fundación Universitaria Sanitas
Clínica Reina Sofía – Clínica Colsanitas
Centro de Columna – Cirugía Mínima Invasiva
Bogotá, D.C.
Colombia
Anthony Yeung
University of New Mexico
School of Medicine
Albuquerque
New Mexico
Hyeun-Sung Kim
Department of Neurosurgery
Nanoori Gangnam Hospital
Seoul
Republic of Korea
Xifeng Zhang
Department of Orthopedics
First Medical Center
PLA General Hospital
Beijing 100853
China
Gun Choi
Neurosurgeon and Minimally Invasive Spine Surgeon
President Pohang Wooridul Hospital
South Korea
Stefan Hellinger
Department of Orthopedic Surgery
Arabellaklinik
Munich
Germany
Álvaro Dowling
Endoscopic Spine Clinic
Santiago
Chile
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PREFACE
Endoscopic surgery of the cervical spine is gaining increasing traction among minimally invasive spinal surgeons. Technology advances with improved miniaturized optical- and surgical access systems have purported expansion of endoscopic minimally invasive spinal surgery techniques into the cervical spine. However, many spine surgeons still hesitate to treat common painful conditions of the cervical spine with endoscopic procedures. The high risk of neurologic- and vascular injury is of concern to many of them. Additionally, damage to the trachea, esophagus, or the recurrent laryngeal nerve may put the patient at significant risk for the deleterious postoperative course. Nevertheless, increased acceptance of endoscopy by traditionally trained spine surgeons in other areas of the spine coupled with more widely available training events and unanswered patient demand has reenergized spine surgeons’ interest in the endoscopic platform for the cervical spine.
The editors have come together to develop a multi-authored and clinically focused medical monograph entitled Contemporary Endoscopic Spine Surgery: Cervical Spine to give the reader a most up-to-date snapshot of the current state-of-the-art of cervical spinal endoscopic surgeries. The publication is intended for Orthopedic Spine & Neurosurgeons interested in treating common painful conditions including herniated disc, stenosis, tumor, and infection with minimally invasive endoscopic techniques. A wide array of highly timely and clinically relevant topics have been assembled for this purpose. They range from suitable anesthesia protocols, patient selection algorithms for anterior versus posterior cervical endoscopic decompression, clinical decision-making strategies, indications, and outcomes for endoscopically visualized cervical rhizotomy to more advanced endoscopic techniques, including complex endoscopic decompression techniques for cervical spondylotic myelopathy and other intricate procedures such as pediculotomy, vertebrectomy, and fusion.
The selection of chapters was based on contemporary trends in endoscopic cervical spine surgery. The editors recognize that this trend is based on the need for less costly yet safe and efficient solutions for the cervical spine's common degenerative conditions. Patients and other stakeholders in the ongoing debate on better value-based spine care, including healthcare policymakers and payors, are demanding of spine surgeons less burdensome and less risky treatments with shorter time to recovery, return to work, and social reintegration following spine surgery. Contemporary Endoscopic Spine Surgery: Cervical Spine was written with these goals in mind. The editors hope that the readers will find it an informative knowledge resource they will continue to revert to when implementing a cervical endoscopic spinal surgery program in their practice setting.
Kai-Uwe Lewandrowski
Discipline of Anesthesiology
Faculty of Medicine of Ribeirão Preto
São Paulo
Brazil Jorge Felipe Ramírez León
Fundación Universitaria Sanitas
Clínica Reina Sofía – Clínica Colsanitas
Centro de Columna – Cirugía Mínima Invasiva
Bogotá, D.C.
Colombia Anthony Yeung
University of New Mexico
School of Medicine
Albuquerque
New Mexico Hyeun-Sung Kim
Department of Neurosurgery
Nanoori Gangnam Hospital
Seoul
Republic of Korea Xifeng Zhang
Department of Orthopedics
First Medical Center
PLA General Hospital
Beijing 100853
China Gun Choi
Neurosurgeon and Minimally Invasive Spine Surgeon
President Pohang Wooridul Hospital
List of Contributors
Anthony YeungUniversity of New Mexico School of Medicine, Albuquerque, New Mexico
Desert Institute for Spine Care, Phoenix, AZ, USAÁlvaro DowlingEndoscopic Spine Clinic, Santiago, Chile
Department of Orthopaedic Surgery, USP, Ribeirão Preto, BrazilBu RongqiangDepartment of Orthopedics, First Medical Center, PLA General Hospital, Beijing 100853, ChinaCarolina Ramírez MartínezMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C., ColombiaCatherine Ann CameronUniversity of British Columbia, Vancouver, BC & University of New Brunswick, Fredericton, NB, CanadaCindy LauIndependent Scholar based in Hong Kong,Enrique Osorio FonsecaUniversidad El Bosque, Bogotá, D.C., ColombiaGabriel Oswaldo Alonso CuéllarMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C., ColombiaHyeun Sung KimDepartment of Neurosurgery, Nanoori Gangnam Hospital, Seoul, South Korea
A President of the Korean Research Society of the Endoscopic Spine Surgery (KOSESS), South Korea
A Faculty of the KOrean Minimally Invasive Spine Surgery Society (KOMISS), South Korea
A Chairman of the Nanoori Hospital Group Scientific Team, South Korea
An Adjunct Professor of the Medical College of the Chosun University, Gwangju, South KoreaIl-Tae JangDepartment of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Republic of Korea, Beijing 100048, ChinaJin-Sung KimSpine Center, Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo Daero, Seocho-gu, Seoul, 137-701, KoreaJoão AbrãoDiscipline of Anesthesiology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, BrazilJulia GillenDepartment of Linguistics and English Language, Lancaster University, Lancaster, UKJun-Song YangDepartment of Spinal Surgery, Hong-Hui Hospital, Medical College of Xi'an Jiaotong University, Xi'an, ChinaJorge Felipe Ramírez LeónMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C., Colombia
Fundación Universitaria Sanitas, Bogotá, D.C., ColombiaJosé Gabriel Rugeles OrtízMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C., ColombiaJorge Felipe Ramírez LeónMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, Bogotá, D.C., Colombia
Universidad El Bosque, Bogotá, D.C., ColombiaJosé Gabriel Rugeles OrtízMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C., ColombiaJiang HongzhenMinimally Invasive Spinal Surgery, Beijing Yuhe Integrated Traditional Chinese and Western Medicine Rehabilitation Hospital, Beijing 100853, ChinaKai-Uwe LewandrowskiCenter for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ, USA
Department of Orthopaedic Surgery, UNIRIO, Rio de Janeiro, Brazil
Department of Orthoapedic Surgery, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia, USA
Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ, USALei ChuDepartment of Orthopaedics, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaLiang ChenDepartment of Orthopaedics, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaLiu Yan-kangShanxi Medical University, Taiyuan 030001, China
Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ, USALi DongzheDepartment of Orthopedics, First Medical Center, PLA General Hospital, Beijing 100853, ChinaLi JinlongDepartment of Orthopedics, The Eighth Medical Center, PLA General Hospital, 100091 Beijing, ChinaMalcolm PestonjiMahatma Gandhi Memorial University of Health Sciences, Navi Mumbai, Kamothe Maharashtra, IndiaNicolás Prada RamírezMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C., Colombia
Colombia Clínica Foscal, Bucaramanga, ColombiaNora DidkowskyIndependent Scholar based in Canada and Switzerland,Pang Hung WuDepartment of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Republic of Korea
Departments of Orthopaedic Surgery, National University Health System, Jurong Health Campus, SingaporeStefan HellingerDepartment of Orthopedic and Spine Surgery, Arabellaklinik, Munich, GermanyWang YipengDepartment of Orthopedics, The Eighth Medical Center, PLA General Hospital, 100091 Beijing, ChinaXi JianchengDepartment of Orthopaedic Surgery, UNIRIO, Rio de Janeiro, BrazilYan Yu-qiuMinimally Invasive Spinal Surgery, Beijing Yuhe Integrated Traditional Chinese and Western Medicine Rehabilitation Hospital, Beijing 100039, ChinaYuan HengShanxi Medical University, Taiyuan 030001, ChinaZhong-Liang DengDepartment of Orthopaedics, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, ChinaZhang Xi-fengDepartment of Orthopedics, First Medical Center, PLA General Hospital, Beijing 100853, ChinaZhang Lei-mingDepartment of Neurosurgery, the Sixth Medical Center, PLA General Hospital, Beijing 100048, ChinaZhu ZexingDepartment of Orthopedics, First Medical Center, PLA General Hospital, Beijing 100853, ChinaZheng ZezeDepartment of Orthopedics, The Eighth Medical Center, PLA General Hospital, 100091 Beijing, China
Cervical Endoscopy: Historical Perspectives, Present & Future
Kai-Uwe Lewandrowski1,2,3,*,Jin-Sung Kim4,Stefan Hellinger5,Anthony Yeung6,7
1 Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ, USA
2 Department of Orthopaedic Surgery, UNIRIO, Rio de Janeiro, Brazil
3 Department of Orthoapedic Surgery, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia, USA
4 Spine Center, Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo Daero, Seocho-gu, Seoul, 137-701, Korea
5 Department of Orthopedic and Spine Surgery, Arabellaklinik, Munich, Germany
6 University of New Mexico School of Medicine, Albuquerque, New Mexico
7 Desert Institute for Spine Care, Phoenix, AZ, USA
Abstract
Endoscopy of the cervical spine traditionally has been slow to adopt. Initially, spinal endoscopy concentrated on common painful degenerative conditions of the lumbar spine, for which many of the technology breakthroughs were developed. Many of them were validated for defined clinical indications, such as a herniated disc. Stenosis applications followed later as improvements in the endoscopic platform permitted. Cervical spine application of endoscopic surgery commenced around interventional pain management with lasers and radiofrequency to improve their reliability by directly visualizing the painful pathology. Later, anterior cervical discectomies and posterior cervical foraminotomies were performed as endoscopic power burrs, and rongeurs made them possible. The most skilled surgeons moved on to perform anterior and posterior cervical spinal cord decompressions and anterior column reconstructions endoscopically further to take advantage of the potential of this platform so they could transform the traditional surgical treatments from inpatient to outpatient by performing them in a simplified manner in ambulatory surgery centers where better clinical outcomes and higher patient satisfaction could be achieved. In this chapter, the authors strove to briefly illustrate this development by giving credit to the
most prominent pioneers of this fast-moving field and by setting the stage for what the reader is about to discover in this most-up-to date publication entitled: Contemporary Spinal Endoscopy: Cervical Spine.
Keywords: Cervical spine, Decompression, Degeneration, Disc herniation, Endoscopic, Historical considerations, Impingement, Lasers, Minimally invasive, Open, Radiofrequency, Stenosis.
*Corresponding author Kai-Uwe Lewandrowski: Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ, USA, Department of Orthopaedic Surgery, UNIRIO, Rio de Janeiro, Brazil and Department of Orthoapedic Surgery, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia, USA; Tel: +1 520 204-1495; Fax: +1 623 218-1215;
E-mail:
[email protected]CONSENT FOR PUBLICATION
Not applicable.
CONFLICT OF INTEREST
This manuscript is not meant for or intended to push any other agenda other than reporting the clinical outcome data following endoscopic spinal decompression. The motive for compiling this clinically relevant information is by no means created and/or correlated to directly enrich anyone due to its publication. The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The first author has no direct or indirect conflicts of interest. The senior author designed and trademarked his inside-out YESS™ technique and receives royalties from the sale of his inventions. Indirect conflicts of interest may exist. Paymnets for honoraria, consultancies to sponsoring organizations are donated to IITS.org, a 501c3 organization.
ACKNOWLEDGEMENTS
Declared none.
REFERENCES
[1]Lewandrowski KU, Soriano-Sánchez JA, Zhang X, et al. Regional variations in acceptance, and utilization of minimally invasive spinal surgery techniques among spine surgeons: results of a global survey. J Spine Surg 2020; 6 (Suppl. 1): S260-74.[http://dx.doi.org/10.21037/jss.2019.09.31] [PMID: 32195433][2]Yeung A, Wei SH. Surgical outcome of workman’s comp patients undergoing endoscopic foraminal decompression for lumbar herniated disc. J Spine Surg 2020; 6 (Suppl. 1): S116-9.[http://dx.doi.org/10.21037/jss.2019.11.03] [PMID: 32195420][3]Yeung A, Lewandrowski KU. Early and staged endoscopic management of common pain generators in the spine. J Spine Surg 2020; 6 (Suppl. 1): S1-5.[http://dx.doi.org/10.21037/jss.2019.09.03] [PMID: 32195407][4]Yeung A, Lewandrowski KU. Five-year clinical outcomes with endoscopic transforaminal foraminoplasty for symptomatic degenerative conditions of the lumbar spine: a comparative study of inside-outversusoutside-in techniques. J Spine Surg 2020; 6 (Suppl. 1): S66-83.[http://dx.doi.org/10.21037/jss.2019.06.08] [PMID: 32195417][5]Ransom NA, Gollogly S, Lewandrowski KU, Yeung A. Navigating the learning curve of spinal endoscopy as an established traditionally trained spine surgeon. J Spine Surg 2020; 6 (Suppl. 1): S197-207.[http://dx.doi.org/10.21037/jss.2019.10.03] [PMID: 32195428][6]Ramírez León JF, Ardila AS, Rugeles Ortíz JG, et al. Standalone lordotic endoscopic wedge lumbar interbody fusion (LEW-LIF™) with a threaded cylindrical peek cage: report of two cases. J Spine Surg 2020; 6 (Suppl. 1): S275-84.[http://dx.doi.org/10.21037/jss.2019.06.09] [PMID: 32195434][7]Qiao G, Feng M, Wang X, et al. Revision for endoscopic diskectomy: is lateral lumbar interbody fusion an option? World Neurosurg 2020; 133: e26-30.[http://dx.doi.org/10.1016/j.wneu.2019.07.226] [PMID: 31398523][8]Mo AZ, Miller PE, Glotzbecker MP, et al. The reliability of the aospine thoracolumbar classification system in children: results of a multicenter study. J Pediatr Orthop 2020; 40(5): e352-6.[http://dx.doi.org/10.1097/BPO.0000000000001521] [PMID: 32032218][9]Lohre R, Wang JC, Lewandrowski KU, Goel DP. Virtual reality in spinal endoscopy: a paradigm shift in education to support spine surgeons. J Spine Surg 2020; 6 (Suppl. 1): S208-23.[http://dx.doi.org/10.21037/jss.2019.11.16] [PMID: 32195429][10]Lewandrowski KU, Yeung A. Meaningful outcome research to validate endoscopic treatment of common lumbar pain generators with durability analysis. J Spine Surg 2020; 6 (Suppl. 1): S6-S13.[http://dx.doi.org/10.21037/jss.2019.09.07] [PMID: 32195408][11]Lewandrowski KU, Ransom NA, Yeung A. Return to work and recovery time analysis after outpatient endoscopic lumbar transforaminal decompression surgery. J Spine Surg 2020; 6 (Suppl. 1): S100-15.[http://dx.doi.org/10.21037/jss.2019.10.01] [PMID: 32195419][12]Lewandrowski KU, Ransom NA, Yeung A. Subsidence induced recurrent radiculopathy after staged two-level standalone endoscopic lumbar interbody fusion with a threaded cylindrical cage: a case report. J Spine Surg 2020; 6 (Suppl. 1): S286-93.[http://dx.doi.org/10.21037/jss.2019.09.25] [PMID: 32195435][13]Lewandrowski KU, Ransom NA. Five-year clinical outcomes with endoscopic transforaminal outside-in foraminoplasty techniques for symptomatic degenerative conditions of the lumbar spine. J Spine Surg 2020; 6 (Suppl. 1): S54-65.[http://dx.doi.org/10.21037/jss.2019.07.03] [PMID: 32195416][14]Lewandrowski KU, DE Carvalho PST, DE Carvalho P, Yeung A. Minimal clinically important difference in patient-reported outcome measures with the transforaminal endoscopic decompression for lateral recess and foraminal stenosis. Int J Spine Surg 2020; 14(2): 254-66.[http://dx.doi.org/10.14444/7034] [PMID: 32355633][15]Lewandrowski KU, Dowling A, de Carvalho P. Indication and contraindication of endoscopic transforaminal lumbar decompression. World Neurosurg 2020; 145: 631-42.[http://dx.doi.org/10.1016/j.wneu.2020.03.076] [PMID: 32201296][16]Lewandrowski KU, Dowling Á, Calderaro AL, et al. Dysethesia due to irritation of the dorsal root ganglion following lumbar transforaminal endoscopy: Analysis of frequency and contributing factors. Clin Neurol Neurosurg 2020; 197: 106073.[http://dx.doi.org/10.1016/j.clineuro.2020.106073] [PMID: 32683194][17]Lewandrowski KU, de Carvalho PST, Calderaro AL, et al. Outcomes with transforaminal endoscopic versus percutaneous laser decompression for contained lumbar herniated disc: a survival analysis of treatment benefit. J Spine Surg 2020; 6 (Suppl. 1): S84-99.[http://dx.doi.org/10.21037/jss.2019.09.13] [PMID: 32195418][18]
