Moderator: Michael Y. Wang, MD
Spine surgery is advancing towards ambulatory centers while same day surgical centers are gaining popularity among spine surgeons. As the number of complex fusion surgeries increase, especially in elderly patients with multiple comorbidities, more than ever there is a need to develop new minimally invasive revision strategies.
The endoscope has enabled spine surgeons to perform several surgeries, which previously required large incisions, through small keyhole incisions. Initial indications were routine discectomy, recurrent disc herniation, far lateral discectomy surgeries to interbody fusion through small incisions. The indications are continuously expanding to include several aspects of spine surgeries such as foraminal decompression at the level of previous fusion for optimal decompression, decompression of adjacent level, and repair and replacement of interbodies.
Patients with mild to moderate spinal deformity are often compensated and have tolerable levels of back pain. However, unilateral radicular pain resulting from foraminal stenosis can be debilitating. In select cases, an endoscopic discectomy or foraminotomy enables the surgeon to decompress the symptomatic foramen with preservation of essential biomechanical structures, delaying the need for a major deformity correction surgery.
Faculty will provide an introduction to endoscopic spine surgery and relevant anatomy as well as address different approaches to spine using case-based examples. Newer approaches and salvage techniques described in recent neurosurgery editions also will be presented. Trouble shooting and complication avoidance will be covered. Fast track approaches to minimally invasive surgery and same day discharge will be discussed.
Upon completion of this session, participants should gain strategies to:
- Gain an overview of endoscopic spine surgery;
- Learn the anatomy of spine through the endoscope including choosing optimal site for the pathology of interest;
- Determine decision-making and approach to endoscopic spine surgery;
- Define endoscopic discectomy and recurrent discectomy;
- Salvage procedure techniques, repair and replacement of interbodies, adjacent level decompression;
- Demonstrate coding and billing of endoscopic procedures.
Agenda
Introduction
Michael Y. Wang, MD
Why You Should Learn Spinal Endoscopy
Karthik Madhavan, MD
Interlaminar Discectomy: Technique and Pearls
William R. Taylor, MD
Transforaminal Discectomy: What Pathology Can Be Accessed?
Sang Ho Lee, MD, PhD
Interlaminar Lumbar Stenosis Decompression: Can It Replace Laminectomy?
Christoph Hofstetter, MD, PhD
Lumbar Endoscopic Fusion Procedures: A Review
Christopher A. Yeung, MD
Thoracic Endoscopic Discectomy: What Lesions Can Be Removed Safely?
Albert Telfeian, MD, PhD
Endoscopy’s Role in an Ambulatory Surgery Center
Choll W. Kim, MD, PhD
Discussion, Question and Answer
Faculty Panel