Lumbar Spine

Technical Pearls for Difficult Cases, Controversies and Complications of Lumbar Endoscopy

Author(s): Ji-Yeon Kim, Hyeun sung Kim*, Kai-Uwe Lewandrowski and Tae Jang

Pp: 270-289 (20)

DOI: 10.2174/9789815051537122020019

* (Excluding Mailing and Handling)

Abstract

Spinal endoscopy has the stigma of being reserved for only a few that figure
out how to master the steep learning curve and develop clinical practice settings where
an endoscopic spine surgery can thrive. In essence, endoscopic treatment of herniated
discs specifically and nerve root compression in the lumbar spine in general amounts to
replacing traditional open spine surgery protocols with spinal endoscopic surgery
techniques. In doing so, the endoscopic spine surgeon must be confident that the
degenerative spine's common painful problems can be handled with the endoscopic
spinal surgery techniques with at least comparable clinical results and complication
rates. This chapter illustrates several complex clinical examples and proposes treatment
algorithms with pertinent pearls and tips for revision and complication cases.


Keywords: Complications, Controversies, Endoscopic techniques, Herniated disc.

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      • 16. app/Models/Subject.php:255
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      • 11. app/Models/ContentAccess.php:647
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      • 11. app/Models/ContentAccess.php:647
      • 12. app/Http/Controllers/ChapterController.php:1478
      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59615104 and j.to_ip >=59615104 )) and ((j.from_date <= 1739987581 and j.to_date >= 1739987581 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 16890) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59615104 and j.to_ip >=59615104 )) and ((j.from_date <= 1739987581 and j.to_date >= 1739987581 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 16890) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59615104 and j.to_ip >=59615104 )) and ((j.from_date <= 1739987581 and j.to_date >= 1739987581 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 16890)
      520μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 3335 and `b`.`banner_from_date` <= 1739987581 and `b`.`banner_to_date` >= 1739987581 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.04msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 3335
      • 3: 1739987581
      • 4: 1739987581
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='c5971ec5ea7e37b78578d401a60e9c57'
      190μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    4Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        JH6GOZzIbvymKDr2x2gXYRTcNzYsNlXhSLfECZBm
        uc_cart_id
        c5971ec5ea7e37b78578d401a60e9c57
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/16890" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/16890
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6IktMTGJFQlVuTWxaY3NHTzZvMTZ4YlE9PSIsInZhbHVlIjoiWnl5ejV5bGFpM3VrWVRwcFdGczg3UmQ1dmU4U3p2cXlzc1pEZSt0NFl6WT0iLCJtYWMiOiI0MjVjMWE0NGFhNWE3YTUzYmU1MzE3NDAyM2UwMTdmOTk2N2QzNjMyZjQ0YjYwNzg2M2ZiOGMyNzA3ZWQzZDE2IiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6IktMTGJFQlVuTWxaY3NHTzZvMTZ4YlE9PSIsInZhbHVlIjoiWnl5ejV5bGFpM3VrWVRwcFdGczg3UmQ1dmU4U3p2cXlzc1pEZSt0NFl6WT0iLCJtYWMiOiI0MjVjMWE0NGFhNWE3" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Wed, 19 Feb 2025 17:53:01 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6ImVRUjc5OHdiemxSS3NwZzROcCs5QlE9PSIsInZhbHVlIjoiUUhGS3hPODlFb3k4T3g1UVFRWTZEcmlJWWhTMDlDbzdnUnVvdnBNa3FvMmpJcU5VN3RPcmJpbFY1bjVFdm8zb0kxbFdJMFZpYmJXOTVob3cwMCtDQzVOa1hxc2FGUzBBY3A3elpEajRBeTNJd0lNOHpSUFkwY1N2L1hTalo2S2QiLCJtYWMiOiJjNTkyMDU3MmY1YjJlMTc3NWYxZDM4ZWZhZWIxMmZjYjhmYzhkMTM0MGZhODA0NzJiNDRmZWU5YjA2MDIzMDZhIiwidGFnIjoiIn0%3D; expires=Sat, 22 Feb 2025 05:53:01 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6ImVRUjc5OHdiemxSS3NwZzROcCs5QlE9PSIsInZhbHVlIjoiUUhGS3hPODlFb3k4T3g1UVFRWTZEcmlJWWhTMDlDbzdnUnVvdnBNa3FvMmpJcU5VN3RPcmJpbFY1bjVFdm8zb0kxbFdJM" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlBBVUp0bExPcFZDK3prMTdZQk0vMUE9PSIsInZhbHVlIjoiWkhVWnk2anBMM2NtRGhyc3FFVkF0Mnpza2ZKcDZHTndoUjZ4ZG55K0tuZDVNaHFINTM2bVZRNDNlaEliL1VWQ2QwN1V2Y0FQZm9XR2hRWmg4bFVqdTB6aTdFNGMzQXhBK1QwandYVUxDaUY2N3lIa1IyVDVaZGk1UkI5VFVvZmsiLCJtYWMiOiJlYTI2MWQ2NDkwMWIzMGQ5YzExNjRlNjdhYzI4ZTUzZDE4MjgzNTU3NzlhNDJjODdjMjlmM2ZhODhlYjE0MTljIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IlBBVUp0bExPcFZDK3prMTdZQk0vMUE9PSIsInZhbHVlIjoiWkhVWnk2anBMM2NtRGhyc3FFVkF0Mnpza2ZKcDZHTndoUjZ4ZG55K0tuZDVNaHFINTM2bVZRNDN" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6ImVRUjc5OHdiemxSS3NwZzROcCs5QlE9PSIsInZhbHVlIjoiUUhGS3hPODlFb3k4T3g1UVFRWTZEcmlJWWhTMDlDbzdnUnVvdnBNa3FvMmpJcU5VN3RPcmJpbFY1bjVFdm8zb0kxbFdJMFZpYmJXOTVob3cwMCtDQzVOa1hxc2FGUzBBY3A3elpEajRBeTNJd0lNOHpSUFkwY1N2L1hTalo2S2QiLCJtYWMiOiJjNTkyMDU3MmY1YjJlMTc3NWYxZDM4ZWZhZWIxMmZjYjhmYzhkMTM0MGZhODA0NzJiNDRmZWU5YjA2MDIzMDZhIiwidGFnIjoiIn0%3D; expires=Sat, 22-Feb-2025 05:53:01 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6ImVRUjc5OHdiemxSS3NwZzROcCs5QlE9PSIsInZhbHVlIjoiUUhGS3hPODlFb3k4T3g1UVFRWTZEcmlJWWhTMDlDbzdnUnVvdnBNa3FvMmpJcU5VN3RPcmJpbFY1bjVFdm8zb0kxbFdJM" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlBBVUp0bExPcFZDK3prMTdZQk0vMUE9PSIsInZhbHVlIjoiWkhVWnk2anBMM2NtRGhyc3FFVkF0Mnpza2ZKcDZHTndoUjZ4ZG55K0tuZDVNaHFINTM2bVZRNDNlaEliL1VWQ2QwN1V2Y0FQZm9XR2hRWmg4bFVqdTB6aTdFNGMzQXhBK1QwandYVUxDaUY2N3lIa1IyVDVaZGk1UkI5VFVvZmsiLCJtYWMiOiJlYTI2MWQ2NDkwMWIzMGQ5YzExNjRlNjdhYzI4ZTUzZDE4MjgzNTU3NzlhNDJjODdjMjlmM2ZhODhlYjE0MTljIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IlBBVUp0bExPcFZDK3prMTdZQk0vMUE9PSIsInZhbHVlIjoiWkhVWnk2anBMM2NtRGhyc3FFVkF0Mnpza2ZKcDZHTndoUjZ4ZG55K0tuZDVNaHFINTM2bVZRNDN" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "JH6GOZzIbvymKDr2x2gXYRTcNzYsNlXhSLfECZBm" "uc_cart_id" => "c5971ec5ea7e37b78578d401a60e9c57" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/16890" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-19 17:53:01GET/chapter/16890112196