Pub Date : 2024-07-01DOI: 10.3171/2024.4.FOCVID2428
Akhade Bhushan Sadashiv, Lokesh Vellore Dasarathan, George Chandy Vilanilam, Sam Scaria, Krishnakumar Kesavapisharady, Easwer Hariharan Venkat
Cortico-amygdalo-hippocampectomy is the most common epilepsy surgery resection in adults and offers excellent outcomes. Seizure outcome benefits range from 75% to 88% with a 2%-4% adverse event rate. The safety profile and outcomes could be enhanced further by clearly defining key surgical landmarks that could also aid tumoral resections in the mesial temporal lobe and selective mesial resections. The authors present their learnings of intraoperative landmarks (cisternal, parenchymal, and vascular) and surgical substeps through an index case of cortico-amygdalo-hippocampectomy with lessons from 820 resections. The video can be found here: https://stream.cadmore.media/r10.3171/2024.4.FOCVID2428.
{"title":"Cisternal, vascular, and parenchymal landmarks in amygdalohippocampectomy for mesial temporal sclerosis: an index case with learnings from 820 resections.","authors":"Akhade Bhushan Sadashiv, Lokesh Vellore Dasarathan, George Chandy Vilanilam, Sam Scaria, Krishnakumar Kesavapisharady, Easwer Hariharan Venkat","doi":"10.3171/2024.4.FOCVID2428","DOIUrl":"10.3171/2024.4.FOCVID2428","url":null,"abstract":"<p><p>Cortico-amygdalo-hippocampectomy is the most common epilepsy surgery resection in adults and offers excellent outcomes. Seizure outcome benefits range from 75% to 88% with a 2%-4% adverse event rate. The safety profile and outcomes could be enhanced further by clearly defining key surgical landmarks that could also aid tumoral resections in the mesial temporal lobe and selective mesial resections. The authors present their learnings of intraoperative landmarks (cisternal, parenchymal, and vascular) and surgical substeps through an index case of cortico-amygdalo-hippocampectomy with lessons from 820 resections. The video can be found here: https://stream.cadmore.media/r10.3171/2024.4.FOCVID2428.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"11 1","pages":"V6"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.3171/2024.4.focvid23219
Sharona Ben-Haim, Dennis Spencer, Jonathan Roth, Howard L. Weiner
{"title":"The technical landscape of modern epilepsy surgery","authors":"Sharona Ben-Haim, Dennis Spencer, Jonathan Roth, Howard L. Weiner","doi":"10.3171/2024.4.focvid23219","DOIUrl":"https://doi.org/10.3171/2024.4.focvid23219","url":null,"abstract":"","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.3171/2024.4.FOCVID244
Santiago E Cicutti, Guido P Gromadzyn, Javier F Cuello, Marcelo Bartuluchi
Vagus nerve stimulation (VNS) is a neuromodulatory treatment involving chronic intermittent electrical stimulation of the left vagus nerve, administered through a programmable pulse generator implanted subcutaneously in the chest. This generator connects to a bipolar lead, with electrodes wrapped around the vagus nerve in the neck. Primarily used as an adjunct therapy for patients with refractory epilepsy who cannot undergo or have not benefitted from resective surgery, VNS is generally well tolerated with few severe side effects. Herein is presented an educational surgical video providing a detailed, step-by-step technical description of VNS implantation. The video can be found here: https://stream.cadmore.media/r10.3171/2024.4.FOCVID244.
{"title":"Vagus nerve stimulation in pediatric patients with drug-resistant epilepsy: a step-by-step video.","authors":"Santiago E Cicutti, Guido P Gromadzyn, Javier F Cuello, Marcelo Bartuluchi","doi":"10.3171/2024.4.FOCVID244","DOIUrl":"10.3171/2024.4.FOCVID244","url":null,"abstract":"<p><p>Vagus nerve stimulation (VNS) is a neuromodulatory treatment involving chronic intermittent electrical stimulation of the left vagus nerve, administered through a programmable pulse generator implanted subcutaneously in the chest. This generator connects to a bipolar lead, with electrodes wrapped around the vagus nerve in the neck. Primarily used as an adjunct therapy for patients with refractory epilepsy who cannot undergo or have not benefitted from resective surgery, VNS is generally well tolerated with few severe side effects. Herein is presented an educational surgical video providing a detailed, step-by-step technical description of VNS implantation. The video can be found here: https://stream.cadmore.media/r10.3171/2024.4.FOCVID244.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"11 1","pages":"V2"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.FOCVID23195
Dimas Rahman Setiawan, Enrico Giordan, Changik Lee, Chan Woong Park, Phattareeya Pholprajug, Jin-Sung Kim
An 84-year-old woman presented with left leg radiating pain for 18 months and a numeric rating scale score of 8. From examination, motoric on left knee extension was grade 4, with dysesthesia and numbness along the left anterolateral thigh. Imaging showed left L3–4 foraminal and lateral recess stenosis with severe-degree scoliosis. The patient underwent navigation-guided endoscopic transforaminal foraminotomy and lateral recess decompression on the left L3–4 level with a good outcome. Three-years’ follow-up showed a well-maintained clinical outcome and coronal sagittal balance. This video explores navigation-guided endoscopic lumbar decompression for neural compression in advanced scoliosis. Further research is encouraged to establish long-term efficacy. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23195
{"title":"Navigation-guided endoscopic lumbar decompression on foramen and lateral recess in advanced scoliosis","authors":"Dimas Rahman Setiawan, Enrico Giordan, Changik Lee, Chan Woong Park, Phattareeya Pholprajug, Jin-Sung Kim","doi":"10.3171/2024.1.FOCVID23195","DOIUrl":"https://doi.org/10.3171/2024.1.FOCVID23195","url":null,"abstract":"An 84-year-old woman presented with left leg radiating pain for 18 months and a numeric rating scale score of 8. From examination, motoric on left knee extension was grade 4, with dysesthesia and numbness along the left anterolateral thigh. Imaging showed left L3–4 foraminal and lateral recess stenosis with severe-degree scoliosis. The patient underwent navigation-guided endoscopic transforaminal foraminotomy and lateral recess decompression on the left L3–4 level with a good outcome. Three-years’ follow-up showed a well-maintained clinical outcome and coronal sagittal balance. This video explores navigation-guided endoscopic lumbar decompression for neural compression in advanced scoliosis. Further research is encouraged to establish long-term efficacy. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23195","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.focvid23182
Ariel Kaen, Javier Quillo-Olvera, Man Kyu Park, Santiago Rocha, Fernando Durand, Ignacio Martin, Sang-Kyu Son
The treatment for lumbar spinal stenosis has advanced through the use of minimally invasive surgery techniques. Endoscopic methods go even further, with studies showing that both uniportal and biportal endoscopic techniques have outcomes comparable to traditional approaches. However, there is limited knowledge of the step-by-step decompression process when using the unilateral biportal endoscopic (UBE). To address this, the authors introduce the five steps in the "Z" sequence, which aims to reduce surgical time and complications. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23182
{"title":"Five-step unilateral biportal endoscopic surgery for central lumbar canal stenosis: \"Z\" technique nuance","authors":"Ariel Kaen, Javier Quillo-Olvera, Man Kyu Park, Santiago Rocha, Fernando Durand, Ignacio Martin, Sang-Kyu Son","doi":"10.3171/2024.1.focvid23182","DOIUrl":"https://doi.org/10.3171/2024.1.focvid23182","url":null,"abstract":"The treatment for lumbar spinal stenosis has advanced through the use of minimally invasive surgery techniques. Endoscopic methods go even further, with studies showing that both uniportal and biportal endoscopic techniques have outcomes comparable to traditional approaches. However, there is limited knowledge of the step-by-step decompression process when using the unilateral biportal endoscopic (UBE). To address this, the authors introduce the five steps in the \"Z\" sequence, which aims to reduce surgical time and complications. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23182","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"342 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140784700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.FOCVID23214
S. Dhandapani, Chandrashekhar Gendle
Minimally invasive surgery (MIS) is increasingly being adopted for spinal intradural tumors. Through the use of conventional microscopy or exoscopy for large lobulated nerve sheath tumors, the posterior root attachment is often visualized only after mobilizing the tumor. Here, the authors describe the utility of angled endoscopy with its panoramic view for a T10 nerve sheath tumor. Gross-total extracapsular excision was achieved utilizing a minimally invasive right paraspinous approach, fenestration, lateral durotomy, sliding delivery of the tumor, sharp dissection of radicular attachments under neuromonitoring, and dural closure with oblique clips. Angled endoscopes help visualize the attachments behind large multilobulated tumors and confirm the totality of excision. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23214
{"title":"Endoscopy for T10 nerve sheath tumor","authors":"S. Dhandapani, Chandrashekhar Gendle","doi":"10.3171/2024.1.FOCVID23214","DOIUrl":"https://doi.org/10.3171/2024.1.FOCVID23214","url":null,"abstract":"Minimally invasive surgery (MIS) is increasingly being adopted for spinal intradural tumors. Through the use of conventional microscopy or exoscopy for large lobulated nerve sheath tumors, the posterior root attachment is often visualized only after mobilizing the tumor. Here, the authors describe the utility of angled endoscopy with its panoramic view for a T10 nerve sheath tumor. Gross-total extracapsular excision was achieved utilizing a minimally invasive right paraspinous approach, fenestration, lateral durotomy, sliding delivery of the tumor, sharp dissection of radicular attachments under neuromonitoring, and dural closure with oblique clips. Angled endoscopes help visualize the attachments behind large multilobulated tumors and confirm the totality of excision. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23214","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"88 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.focvid23176
David T. Fernandes Cabral, R. J. Fernandez-de Thomas, Ali A. Alattar, David A. Paul, Eric W Wang, Paul A. Gardner
Odontoid pannus is an abnormal collection of degenerative or inflammatory tissue on the C1-dens joint that can result in severe spinal cord compression myelopathy. Treatment options vary depending on severity and etiology. In cases of severe cord compression, surgical management could be either through a purely posterior approach or in combination with an anterior decompression via endoscopic endonasal approach (EEA). This case presents a 77-year-old female who underwent posterior cervical fixation for odontoid pannus causing dramatic cervical myelopathy who failed to improve over a 6-month period and required anterior transodontoid pannus resection and decompression via EEA. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23176
{"title":"Endoscopic endonasal approach for resection of odontoid process, decompression of the cervicomedullary junction spinal cord, and resection of pannus","authors":"David T. Fernandes Cabral, R. J. Fernandez-de Thomas, Ali A. Alattar, David A. Paul, Eric W Wang, Paul A. Gardner","doi":"10.3171/2024.1.focvid23176","DOIUrl":"https://doi.org/10.3171/2024.1.focvid23176","url":null,"abstract":"Odontoid pannus is an abnormal collection of degenerative or inflammatory tissue on the C1-dens joint that can result in severe spinal cord compression myelopathy. Treatment options vary depending on severity and etiology. In cases of severe cord compression, surgical management could be either through a purely posterior approach or in combination with an anterior decompression via endoscopic endonasal approach (EEA). This case presents a 77-year-old female who underwent posterior cervical fixation for odontoid pannus causing dramatic cervical myelopathy who failed to improve over a 6-month period and required anterior transodontoid pannus resection and decompression via EEA. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23176","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"664 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.focvid23209
Nelson Sofoluke, Jannik Leyendecker, C. P. Hofstetter, Sanjay Konakondla
Spontaneous CSF leaks frequently cause headaches, meningismus, and nausea due to intracranial hypotension. When conservative treatment fails, surgical repair is indicated. Especially ventral leaks necessitate invasive approaches with substantial blood loss and tissue trauma. Full endoscopic spine surgery (FESS) enables circumferential access via the transforaminal approach. Here, the authors show the successful repair of a ventral CSF leak in the thoracic spine after removal of bony osteophytes utilizing FESS with placement of a dural substitute and sealant. Lasting symptom relief was reported. These results suggest that FESS is safe and efficient for the repair of spontaneous and incidental CSF leaks. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23209
{"title":"Full endoscopic resection of ventral thoracic osteophyte and repair of spontaneous CSF leak","authors":"Nelson Sofoluke, Jannik Leyendecker, C. P. Hofstetter, Sanjay Konakondla","doi":"10.3171/2024.1.focvid23209","DOIUrl":"https://doi.org/10.3171/2024.1.focvid23209","url":null,"abstract":"Spontaneous CSF leaks frequently cause headaches, meningismus, and nausea due to intracranial hypotension. When conservative treatment fails, surgical repair is indicated. Especially ventral leaks necessitate invasive approaches with substantial blood loss and tissue trauma. Full endoscopic spine surgery (FESS) enables circumferential access via the transforaminal approach. Here, the authors show the successful repair of a ventral CSF leak in the thoracic spine after removal of bony osteophytes utilizing FESS with placement of a dural substitute and sealant. Lasting symptom relief was reported. These results suggest that FESS is safe and efficient for the repair of spontaneous and incidental CSF leaks. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23209","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"258 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.FOCVID23216
Ashutosh Kumar, A. Srivastava, Jayesh Sardhara, A. Mehrotra, K. Bhaisora, Raj Kumar
This presentation showcases an endoscopic minimally invasive spine surgery (MISS) technique for lumbar interbody fusion. Significantly expanding the scope of Destandau’s system within MISS, it serves as a pivotal link to unilateral biportal endoscopy (UBE) for endofusion. The method involves minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using a 4-mm rigid endoscope through Destandau’s system. With the widespread familiarity with Destandau’s system and the absence of specialized instrument requirements, this approach is easily adoptable, particularly in resource-limited centers. The favorable clinical and radiological outcomes underscore the effectiveness of this technique, propelling the role of endoscopy in MISS, particularly in endofusion. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23216
本讲座展示了一种用于腰椎椎间融合术的内窥镜微创脊柱手术（MISS）技术。它大大扩展了 Destandau 系统在 MISS 中的应用范围，是单侧双侧内窥镜（UBE）进行内灌注的关键环节。该方法包括使用 4 毫米硬质内窥镜通过 Destandau 系统进行微创经椎间孔腰椎椎体间融合术（MIS-TLIF）。由于 Destandau 系统已被广泛熟知，而且不需要专门的器械，因此这种方法很容易被采用，尤其是在资源有限的中心。良好的临床和放射学效果凸显了这一技术的有效性，推动了内窥镜在 MISS 中的作用，尤其是在内膜灌注中的作用。视频请点击： https://stream.cadmore.media/r10.3171/2024.1.FOCVID23216
{"title":"Endoscopic MIS-TLIF with Destandau’s system: leveraging endoscopy with conventional instruments","authors":"Ashutosh Kumar, A. Srivastava, Jayesh Sardhara, A. Mehrotra, K. Bhaisora, Raj Kumar","doi":"10.3171/2024.1.FOCVID23216","DOIUrl":"https://doi.org/10.3171/2024.1.FOCVID23216","url":null,"abstract":"This presentation showcases an endoscopic minimally invasive spine surgery (MISS) technique for lumbar interbody fusion. Significantly expanding the scope of Destandau’s system within MISS, it serves as a pivotal link to unilateral biportal endoscopy (UBE) for endofusion. The method involves minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using a 4-mm rigid endoscope through Destandau’s system. With the widespread familiarity with Destandau’s system and the absence of specialized instrument requirements, this approach is easily adoptable, particularly in resource-limited centers. The favorable clinical and radiological outcomes underscore the effectiveness of this technique, propelling the role of endoscopy in MISS, particularly in endofusion. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23216","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"138 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140791977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.FOCVID23206
Michael E. Tawil, Timothy Chryssikos, Abraham Dada, Vardhaan S. Ambati, Mohamed Macki, Samer G. Zammar, Wei Tan, Lee Tan
Minimally invasive ultrasound during tubular microdiscectomy is novel. The authors report the technique during surgery for L5–S1 herniated disc. Ultrasound provided real-time visualization of the pathology and neural elements. After discectomy and tactile assessment, ultrasound showed decompression of the thecal sac and traversing nerve root. The patient tolerated the procedure well, with resolution of preoperative pain and strength improvement. Postoperative MRI revealed a residual asymptomatic disc fragment that was retrospectively identified on ultrasonography. Minimally invasive ultrasound could become a useful supplement to direct visual and tactile assessment during tubular microdiscectomy, but further experience with surgical anatomy on ultrasound is required. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23206
{"title":"Use of minimally invasive ultrasound transducer during tubular microdiscectomy","authors":"Michael E. Tawil, Timothy Chryssikos, Abraham Dada, Vardhaan S. Ambati, Mohamed Macki, Samer G. Zammar, Wei Tan, Lee Tan","doi":"10.3171/2024.1.FOCVID23206","DOIUrl":"https://doi.org/10.3171/2024.1.FOCVID23206","url":null,"abstract":"Minimally invasive ultrasound during tubular microdiscectomy is novel. The authors report the technique during surgery for L5–S1 herniated disc. Ultrasound provided real-time visualization of the pathology and neural elements. After discectomy and tactile assessment, ultrasound showed decompression of the thecal sac and traversing nerve root. The patient tolerated the procedure well, with resolution of preoperative pain and strength improvement. Postoperative MRI revealed a residual asymptomatic disc fragment that was retrospectively identified on ultrasonography. Minimally invasive ultrasound could become a useful supplement to direct visual and tactile assessment during tubular microdiscectomy, but further experience with surgical anatomy on ultrasound is required. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23206","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"200 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140780442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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