Pain physician
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Foot drop that results from compression of the exiting L5 nerve as a result of far lateral disc herniation (FLDH) at L5-S1 poses a significant surgical challenge to the minimally-invasive spine surgeon given the narrow corridor for an extraforaminal approach because of the high iliac crest. ⋯ Endoscopic spine surgery, minimally-invasive, transforaminal, foot drop, far lateral disc herniation.
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There is an increasing local application of methylene blue (MB) in the treatment of discogenic low back pain (LBP) and percutaneous transforaminal endoscopic discectomy (PTED) procedures. MB could generate DNA damage and induce apoptosis in different cell types; however, the effects of MB on intervertebral disc (IVD) annulus fibrosus (AF) cells are not clearly understood. ⋯ Methylene blue, annulus fibrosus cell, proliferation, apoptosis, paracrine.
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Transforaminal endoscopic lumbar disc decompression (TELD) has emerged as a treatment alternative to open lumbar discectomy, but rates of herniated lumbar disc (HLD) recurrence after TELD are higher by comparison. ⋯ Disc herniation, lumbar, endoscopic, recurrence, early.
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Observational Study
Radiation Dose Practice Audit of 6,234 Fluoroscopically-Guided Spinal Injections.
Fluoroscopic imaging guidance is frequently used in performing spinal interventional techniques. Reference level standards are a quality improvement tool to help reduce radiation dose and serve as benchmarks for physicians and their technologists to achieve reasonable radiation exposure while performing fluoroscopically-guided spinal procedures. There are limited data describing radiation dose for musculoskeletal injections - in particular, spinal injections without any published reference standards. ⋯ Spinal procedures, radiation dose, patient safety.
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Recently posterior cervical foraminotomy (PCF) performed using a minimally-invasive surgery (MIS) approach for cervical radiculopathy due to lateral disc herniation or osseous foraminal stenosis has gained popularity. As 2 dominating MIS techniques, whether FE-PCF or MI-PCF provides superior clinical outcomes remains controversial. ⋯ Cervical radiculopathy, full-endoscopic, microendoscopic, posterior cervical foraminotomy, clinical outcome, complication, reoperation, meta-analysis.