Tubular spinal micro decompression surgery with integrated 2D camera visualization: initial experience and...

Area of Science:

• Neurosurgery
• Spinal Surgery
• Minimally Invasive Spine Surgery (MISS)

Background:

• A novel 2D camera visualization system offers magnified views of the surgical field via a tubular retractor.
• This system represents a new technology for surgical visualization.

Purpose of the Study:

• To report the initial experience with a 2D camera-based visualization system for tubular spinal micro decompression surgery.
• To evaluate the feasibility and outcomes of this novel system in Tanzania.

Main Methods:

• A prospective cohort study included 17 patients with lumbar spinal stenosis or disc herniation.
• Data collected included demographics, surgical details, complications, hospital stay, and Numeric Rating Scale (NRS) scores over six months.
• Descriptive analysis was performed on the collected data.

Main Results:

• The study included 17 patients (59% male, mean age 61 years) with L4-L5 spinal stenosis being most common (65%).
• Mean preoperative NRS score was 8, with significant improvement sustained over six months.
• Durotomy occurred in 29% of patients, primarily during the first year, but no intraoperative nerve injuries were observed. Median hospital stay was 3 days, and 1 patient (6%) developed SSI.

Conclusions:

• The tubular-mounted digital camera visualization system is a feasible adjunct for MISS in Tanzania.
• The system provides advantages in ergonomics, training, and cost-effectiveness over operative microscopy.
• Outcomes improved with experience, despite an initial learning curve associated with durotomy.