Minimally Invasive Spine Surgery and Posterolateral Endoscopic Discectomy Gabriele Jasper, M.D. Anesthesiologist Interventional Pain Physician Center for Pain Control Brick, NJ Milltown, NJ - PowerPoint PPT Presentation

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Minimally Invasive Spine Surgery and Posterolateral Endoscopic Discectomy Gabriele Jasper, M.D. Anesthesiologist Interventional Pain Physician Center for Pain Control Brick, NJ Milltown, NJ

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Minimally Invasive Spine Surgery and Posterolateral Endoscopic Discectomy Gabriele Jasper, M.D. Anesthesiologist Interventional Pain Physician Center for Pain Control – PowerPoint PPT presentation

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Title: Minimally Invasive Spine Surgery and Posterolateral Endoscopic Discectomy Gabriele Jasper, M.D. Anesthesiologist Interventional Pain Physician Center for Pain Control Brick, NJ Milltown, NJ


1
Minimally Invasive Spine Surgery and
Posterolateral Endoscopic DiscectomyGabriele
Jasper, M.D.AnesthesiologistInterventional
Pain PhysicianCenter for Pain ControlBrick, NJ
Milltown, NJ
2
Common Indications- Posterolateral Endoscopic
Discectomy
  • A patient with back pain and/or radicular pain
    who has failed conservative treatment
  • 2. Any herniation accessible endoscopically
    (directly proportional to experience)
  • 3. Patient who refuses open surgery
  • 4. Discogenic Pain
  • 5. Discitis

3
Contraindications - Endoscopic Spine
  • Any pathology not accessible from the
    posterolateral endoscopic approach
  • Severe central canal stenosis
  • Inadequate support staff or equipment to
    successfully perform procedure
  • Uncooperative patient
  • Instability

4
  • Surgical Approach
  • Kambins Triangle

Exiting Nerve
Transversing Nerve Root
Endplate
5
MRI with HNP and Facet HypertrophyNeuroforaminal
Stenosis
T2 axial MRI showing HNP left L4-L5 with
compression of L5 nerve root
T2 sagittal MRI showing HNP, left L4-L5 with
compression of L5 nerve root
6
The Inside Out TechniqueThe Outside Inside
Technique
7
Disc Approaches
8
The Endoscopic Approach
  • Surgical approach
  • The interventional pain approach
  • The modified surgical/interventional pain approach

9
Surgical Approach
10
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11
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12
Interventional Pain Approach
13
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14
Endoscopic HydroDiscectomy Instrumentation
SpineJet EndoResector
15
Endoscopic Discectomy with Foraminotomy and
Annuloplasty
16
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17
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18
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19
Defect Created By the EndoResector
20
Pre-op Orders
  • Standard Pre-op Orders
  • Ancef 1gm I.V. or Gentamycin
  • All solutions that enter the disc need to have
    10 antibiotic

21
Post-operative Orders
  • 1.Follow-up one week
  • 2. Back Brace during activity for six
  • weeks
  • No work 1-2 weeks (depends on type of work)
  • No heavy lifting until re-evalution
  • Pain Medication

22
  • Questions ??

23
Thank You
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