An Experimental Model for Fluid Dynamics and Pressures During Endoscopic Lumbar Discectomy

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Biomedical Engineering

Background:

• Full-endoscopic lumbar discectomy (FELD) is a minimally invasive spine surgery technique.
• Potential irrigation-related complications include headache, seizure, and autonomic dysreflexia.
• Elevated pressure from fluid irrigation may cause these adverse events, but a validated model for study is lacking.

Purpose of the Study:

• To develop and validate an experimental model for FELD.
• To enable repeatable and sensitive measurement of intracranial, intra-, and epidural pressures during spine endoscopy.
• To investigate parameters for defining safe irrigation guidelines.

Main Methods:

• A cadaveric model was established using human cadavers.
• Intradural, lumbar epidural, and intracranial catheters were placed.
• Pressure changes were continuously monitored during simulated FELD at L3-4, including backflow-occlusion tests.

Main Results:

• The experimental model demonstrated reproducibility and validated catheter placement.
• Stable compartmental pressure baselines were achieved across multiple levels.
• Sensitive detection of pressure increases was confirmed using backflow-occlusion.

Conclusions:

• A feasible, repeatable, and precise pressure measurement setup for FELD was developed.
• This model facilitates the investigation of endoscopic techniques and pump pressures.
• It enables the establishment of safe pump pressure ranges for clinical application.