Endoscopic spinal surgery using a new tubular retractor with 15 mm outer diameter

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery

Background:

• Degenerative spinal disorders cause significant radicular pain and sensorimotor deficits.
• Endoscopic techniques offer potential advantages in spinal decompression.

Purpose of the Study:

• To evaluate the adequacy of instrument handling and image quality in endoscopic spinal decompression.
• To assess the impact of these factors on treating degenerative spinal disorders.

Main Methods:

• Forty-six patients underwent endoscopic decompression using a 15mm tubular retractor.
• Surgical video review for instrument handling and complications.
• Clinical outcomes assessed via Oswestry Disability Index (ODI), Neck Disability Index (NDI), Odoms criteria, and physical examination.

Main Results:

• High success rates: 93.9% lumbar and 85.7% cervical patients free of radicular pain.
• Significant improvement in motor function: 84.9% lumbar and 85.7% cervical.
• Low complication rates: 4.3% dural tear (endoscopically repaired), 6.1% recurrent disc herniation.

Conclusions:

• A 15mm tubular retractor provides excellent surgical field visualization for endoscopic spinal decompression.
• This technique achieves high clinical success rates for degenerative spinal pathologies.
• Bimanual technique for decompression is not limited by the 15mm tubular retractor.