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Related Experiment Video

Updated: Aug 3, 2025

Laminotomy for Lumbar Dorsal Root Ganglion Access and Injection in Swine

Laminotomy for Lumbar Dorsal Root Ganglion Access and Injection in Swine

Published on: October 10, 2017

Bone wax technique for full-endoscopic lumbar laminotomy.

Tatsushi Inoue^1,2, Masahiro Joko¹, Fumiaki Saito³

¹Department of Neurosurgery, Fujita Health University, Toyoake, Japan.

Journal of Spine Surgery (Hong Kong)

|April 11, 2023

Summary

A novel bone wax technique (BWT) improves hemostasis in full-endoscopic spine surgery (FESS). This enhanced method facilitates bone wax delivery through endoscopes, overcoming previous handling challenges during irrigation.

Keywords:

Bone wax full-endoscopic spine surgery (FESS)hemostasis

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Last Updated: Aug 3, 2025

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Area of Science:

Neurosurgery
Minimally Invasive Surgery
Surgical Technology

Background:

Hemostasis remains a challenge in full-endoscopic spine surgery (FESS), particularly under continuous irrigation.
Previous bone wax techniques for cervical FESS faced handling difficulties in lumbar FESS due to irrigation and narrow channels.
Challenges include bone wax sticking in the working channel, leading to material loss and visual field obstruction.

Purpose of the Study:

To present a renewed bone wax technique (BWT) for effective hemostasis in full-endoscopic lumbar spine surgery.
To address the difficulties in handling bone wax within the endoscope's working channel during FESS.

Main Methods:

A modified bone wax technique (BWT) was developed, incorporating a nozzle applicator for improved handling.
The nozzle-loaded bone wax facilitates precise delivery to bleeding sites within the endoscope's working channel.
Technical details of using the nozzle-applicator BWT in FESS are demonstrated.

Main Results:

The renewed BWT with a nozzle applicator significantly improves the handling of bone wax during FESS.
This technique prevents bone wax from sticking to the endoscope's working channel, ensuring efficient delivery.
It mitigates issues like material loss, lens soiling, and visual field obstruction during the procedure.

Conclusions:

The nozzle-applicator bone wax technique offers a practical solution for hemostasis in full-endoscopic spine surgery.
This advancement enhances the feasibility and safety of endoscopic spine procedures by improving bleeding control.
The technique is crucial for overcoming previous limitations in endoscopic hemostasis, particularly in lumbar FESS.