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Fulltext A Rare Incidence of Breakage of tip of Micropituitary Forceps during Percutaneous Discectomy - How to Remove it: A Case Report

Sureisen M, Tan BB, Teo YY, Wong CC

Malays Orthop J, 2015 Nov;9(3):58-60.
PMID: 28611913 MyJurnal DOI: 10.5704/MOJ.1511.009

Breakage of the tip of the micropituitary forceps during spine surgery is a rare occurrence. Retrieval of the broken tip could be a challenge in minimally invasive surgeries due to limitation of access and retrieval instruments. We describe our experience in handling such a situation during percutaneous radiofrequency discectomy. The removal was attempted, without converting into open surgery, by utilising percutaneous endoscopic lumbar discectomy working cannula and guided by image intensifier. We were able to remove the fragment without any significant morbidity to the patient. This technique for removal has not been reported previously in the literature.

Matched MeSH terms: Diskectomy; Diskectomy, Percutaneous
Fulltext Cauda Equina Syndrome: A Review of 15 Patients Who Underwent Percutaneous Transforaminal Endoscopic Lumbar Discectomy (PTELD) Under Local Anaesthesia

Krishnan A, Kohli R, Degulmadi D, Mayi S, Ranjan R, Dave B

Malays Orthop J, 2020 Jul;14(2):101-110.
PMID: 32983384 DOI: 10.5704/MOJ.2007.019

Introduction: To analyse the results of Cauda Equina Syndrome (CES) operated by Percutaneous Transforaminal Endoscopic Lumbar Discectomy (PTELD).
Material and Methods: The study is a retrospective series of 15 patients operated by PTELD. Bladder dysfunction was classified as incomplete CES (CESI) and complete CES retention (CESR). Bladder / motor recovery rate and its timing, Oswestry Disability Index (ODI), Visual Analogue Score (VAS), patient satisfaction index, and sexual dysfunction were used to measure the outcome objectively. Additionally, in CESR patients, post-void residual (PVR) urine was measured by sonography. Complications and technical problems were noted.
Results: There were ten patients of CESI and five patients of CESR. The average follow-up was 20.33(12.05) months. Bladder symptoms recovery was 100%, and motor recovery was 80%. VAS for back pain recovered to 0.53(0.52) from 8(2.39). VAS for leg pain recovered to 0.13(0.35) from 9.20(1.32). ODI improved to 6.07(2.85) from 77.52(13.20). The time to the recovery of bladder function was 1.47(1.55) days. All CESR patient's abnormal PVR urine was normalised at five weeks post-operative. No complications were reported. However, five technical executional problems occurred.
Conclusion: PTELD can be considered for CES treatment due to its substantial and quick recovery advantages. However, more evidence support is needed to make it a practice recommendation.

Matched MeSH terms: Diskectomy, Percutaneous
Fulltext Comparison of Fusion Rate Between Autogenous Tricortical Iliac Crest Bone Graft and Hydroxyapatite Block Graft inAnterior Cervical Discectomy and Fusion Surgery

Zulkefli, A., Jeyasilan, K., Zairul, A.K.B., Ramanathan, R.

Malays Orthop J, 2009;3(2):36-39.
MyJurnal

Objective: To compare the fusion rate between autogenous tricortical iliac crest bone graft and hydroxyapatite block graft in anterior cervical discectomy and fusion (ACDF) surgery. Methodology: Retrospective review of cases that underwent ACDF surgery between 2005 and 2008. They were divided into two groups based on the graft material used. Assessment of fusion at 6 months post-surgery was carried out based on the static lateral cervical radiograph. Results: 32 cases were reviewed; 16 in each arm. There were 29 discectomies performed in the hydroxyapatite group as compared to 22 in the iliac crest group. 18 levels in the hydrxyapatite group showed radiological fusion while in the iliac crest group there were 21 levels fused. Seven patients had donor site pain. Conclusion: The fusion rate for autogenous tricortical iliac crest bone graft in anterior cervical discectomy and fusion surgery was 95%, a more superior fusion rate than that of hydroxyapatite block graft which was 62.1%.

Matched MeSH terms: Diskectomy
Dislocation of cervico-thoracic spine with no neurological deficit--a case report

Saw A, Sengupta S

Injury, 2001 Jun;32(5):430-2.
PMID: 11382432
Matched MeSH terms: Diskectomy/methods