Duckbill Release Technique for the Outside-in Method in Full-Endoscopic Spine Surgery via Transforaminal Approach: A Technical Note

Abstract

Background

In full-endoscopic spine surgery via transforaminal approach (FESS-TF), the outside-in method facilitates treatment for various cases; however, the technique is difficult to perform. To facilitate this procedure, we developed a duckbill release technique. In this article, we aimed to introduce the details of this technique and investigate its effectiveness.

Methods

Fifty patients who underwent FESS-TF for intervertebral disc herniation were divided into 2 groups: the conventional technique and the duckbill release technique groups. The time from the initiation of surgery to exposure of the bone outside the superior articular process was measured in both groups. The visual analog scale score for leg pain and the Japanese Orthopaedic Association score before and after surgery were compared in terms of clinical outcomes.

Results

No significant differences were observed between the 2 groups in terms of patient background. The approach time was 252 ± 86 seconds in the conventional group, while it was 105 ± 26 seconds in the duckbill release group, which was significantly shorter (P < 0.001). In terms of clinical outcomes, the 2 groups did not significantly differ in all endpoints of the visual analog scale score for leg pain or the Japanese Orthopaedic Association score.

Conclusions

The duckbill release technique for the outside-in method in FESS-TF could be efficient because it is a simple and time-saving approach.