Spinal Anaesthesia in Spinal Surgery (original) (raw)

Minimally Invasive Spinal Surgery

International Journal of Computer Assisted Radiology and Surgery, 2008

Minimally invasive surgery offers quicker recovery and less morbidity for our patients through smaller surgical wounds and less tissue trauma. Although minimally invasive surgery has progressed in other fields of surgery for many years, spine surgeons have not previously embraced this philosophy for the various reasons discussed. However, minimally invasive spinal surgery has gained much interest in recent years. With the advent of new instrumentation, technology, and techniques, the promise of minimally invasive surgery in the spinal arena has become a reality. With the use of the microscope, navigational tools, newly developed canula for retraction, and image-guided percutenous pedicle screw systems, we can accomplish the same surgical procedures as currently used through smaller wounds and with greater precision. Nevertheless, all new technology does offer us an initial challenge of steep learning curves. Minimally invasive should not equate to minimal and inadequate treatment for our patients. Furthermore, careful analysis of this new technique is underway to assess its true advantages as compared with our current and proven techniques.

Minimally invasive exposure techniques in spine surgery

Current Opinion in Orthopaedics, 2006

Purpose of review Minimally invasive spine surgery is a rapidly growing field of significant interest to both surgeons and patients. Recent advances in surgical technology and technique now enable the spinal surgeon to access the spine whilst preserving the surrounding soft tissues; thereby decreasing postoperative pain. Recent findings In recent years, a variety of technological advances in microscopy, tissue retractors and specialized instruments have become available which make small incision spinal surgery possible. Currently, a variety of spinal pathologies including herniated discs, spinal stenosis and some forms of spinal instability can be successfully treated with a minimally invasive spine surgery approach. Although small incision spinal surgery has a definable learning curve, most patients requiring a lumbar decompression for a localized spinal pathology would be potential candidates for this approach. Certain new skills must be mastered by the spinal surgeon to allow safe and efficient surgery to be performed with the minimally invasive approach. Summary Minimally invasive spine surgery is a promising area of surgery with the potential to significantly decrease the perioperative morbidity to patients requiring spinal surgery. Surgical skills to perform these procedures can be gained through instruction. In the future, well designed clinical outcome studies are needed to define the benefits of minimally invasive spine surgery in comparison with the traditional surgical approaches.

Minimally invasive spinal surgery: a historical perspective

Neurosurgical Focus, 2004

The concept of minimally invasive spinal surgery embodies the goal of achieving clinical outcomes comparable to those of conventional open surgery, while minimizing the risk of iatrogenic injury that may be incurred during the exposure process. The development of microscopy, laser technology, endoscopy, and video and image guidance systems provided the foundation on which minimally invasive spinal surgery is based. Minimally invasive treatments have been undertaken in all areas of the spinal axis since the 20th century. Lumbar disc disease has been treated using chemonucleolysis, percutaneous discectomy, laser discectomy, intradiscal thermoablation, and minimally invasive microdiscectomy techniques. The initial use of thoracoscopy for thoracic discs and tumor biopsies has expanded to include deformity correction, sympathectomy, vertebrectomy with reconstruction and instrumentation, and resection of paraspinal neurogenic tumors. Laparoscopic techniques, such as those used for appendectomy or cholecystectomy by general surgeons, have evolved into procedures performed by spinal surgeons for anterior lumbar discectomy and fusion. Image-guided systems have been adapted to facilitate pedicle screw placement with increased accuracy. Over the past decade, minimally invasive treatment of cervical spinal disorders has become feasible by applying technologies similar to those developed for the thoracic and lumbar spine. Endoscope-assisted transoral surgery, cervical laminectomy, discectomy, and foraminotomy all represent the continual evolution of minimally invasive spinal surgery. Further improvement in optics and imaging resources, development of biological agents, and introduction of instrumentation systems designed for minimally invasive procedures will inevitably lead to further applications in minimally invasive spine surgery.

The Role of Minimally Invasive Spine Surgery

2020

Introduction :In the past half of century, the spinal surgery techniques has advanced significantly. Along with the improvement and various of techniques and technologies in general, there has been a big movement to reduce the morbidity of surgery. Case review : As opposed to open spine surgery, minimally invasive surgical approaches can be faster, safer and require less recovery time. The minimally invasive spine surgery also need to make an efficient target of surgery. The roots in minimally invasive spine surgery (MISS) are based primarily on technique modifications. Discussion: The Williams microdiscectomy, described in 1978, revolutionized MISS by starting the evolution of lumbar discectomy from an open surgery through a 6-inch incision to a microsurgical approach through as small an opening as possible. Conclusion :We don’t use the MISS technique when the extension of tumor is more than 2 levels; extension of the tumor is 20% longer than diameter of largest retractor; the tumo...

Chapter 1 Spinal Anaesthesia in Spinal Surgery

2014

Surgery for lumbar disc prolapse is one of the most common spinal procedures. Lumbar microdiscectomy is usually performed under general anaesthesia despite recent publications showed that these procedures can be performed safely also under spinal anaesthesia. Indeed, some authors have previously highlighted the possibility of using spinal anaesthesia for decompressive laminectomy and microdiscectomy, so avoiding the risks related to the general anaesthesia and allowing to reduce the length of the inpatient stay and the overall costs. In this chapter we will also expose different surgical procedures performed with local and general anaesthesia as well and we will give the possibility to the reader to realize the mean important differences with the use of the spinal anaesthesia.

Percutaneous Lumbar Discectomy

Image-Guided Spine Interventions, 2010

Estimated to cost the United States health care system more than $20 billion a year, 1,2 discogenic leg pain represents the primary cause of health care expenditure. Taken together, back pain and discogenic leg pain result in more days lost than any other combined illnesses and injuries.

Current Minimally Invasive Surgical Techniques in Narrowed Spinal Canal

Mustafa Kemal Üniversitesi Tıp Dergisi, 2013

Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and mainly problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with many advantages such as less bleeding, smaller incisions, little muscle distraction and quicker patient recovery. This paper will review the techniques of performing ipsilateral or bilateral decompressions using some microsurgical instruments (microscope, endoscope) and Kit (mild).