Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique
This video presents a case of L4–5 unstable spondylolisthesis treated with full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), emphasizing the GUARD (Glider Used as a Rotary Device) technique for nerve root protection. This innovative approach involves controlled rotation of the cage...
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Korean Spinal Neurosurgery Society
2024-12-01
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| Series: | Neurospine |
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| Online Access: | http://e-neurospine.org/upload/pdf/ns-2449126-563.pdf |
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| author | Yu-Chia Hsu Hao-Chun Chuang Wei-Lun Chang Yuan-Fu Liu Chao-Jui Chang Yu-Meng Hsiao Yi-Hung Huang Keng-Chang Liu Chien-Min Chen Hyeun-Sung Kim Cheng-Li Lin |
| author_facet | Yu-Chia Hsu Hao-Chun Chuang Wei-Lun Chang Yuan-Fu Liu Chao-Jui Chang Yu-Meng Hsiao Yi-Hung Huang Keng-Chang Liu Chien-Min Chen Hyeun-Sung Kim Cheng-Li Lin |
| author_sort | Yu-Chia Hsu |
| collection | DOAJ |
| description | This video presents a case of L4–5 unstable spondylolisthesis treated with full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), emphasizing the GUARD (Glider Used as a Rotary Device) technique for nerve root protection. This innovative approach involves controlled rotation of the cage glider before cage insertion to minimize the risk of nerve root injury, a significant complication in Endo-TLIF procedures. The GUARD technique, validated in previous cadaveric studies, provides enhanced safety during cage insertion by protecting the nerve root. A 48-year-old woman with a 3-year history of progressive low back pain and bilateral lower extremity radiculopathy (right-sided predominance) was diagnosed with L4–5 unstable spondylolisthesis and spinal stenosis. After failure of conservative management, she underwent uniportal full-endoscopic facet-resecting transforaminal lumbar interbody fusion using the GUARD technique. Postoperatively, the patient experienced significant symptomatic improvement and resolution of radiculopathy, without any intraoperative nerve root injury or postoperative neurological deficits. This case demonstrates the effectiveness of the GUARD technique in reducing neurological complications and improving patient outcomes. |
| format | Article |
| id | doaj-art-dc96a3007ced40c1bfb0fd76ea74ca40 |
| institution | DOAJ |
| issn | 2586-6583 2586-6591 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj-art-dc96a3007ced40c1bfb0fd76ea74ca402025-08-20T03:04:38ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912024-12-012141141114810.14245/ns.2449126.5631652Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) TechniqueYu-Chia Hsu0Hao-Chun Chuang1Wei-Lun Chang2Yuan-Fu Liu3Chao-Jui Chang4Yu-Meng Hsiao5Yi-Hung Huang6Keng-Chang Liu7Chien-Min Chen8Hyeun-Sung Kim9Cheng-Li Lin10 Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Orthopedic Surgery, Dou-Liou Branch of National Cheng Kung University Hospital, Yunlin, Taiwan Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Orthopedic Surgery, Dou-Liou Branch of National Cheng Kung University Hospital, Yunlin, Taiwan Department of Orthopedics, Tainan Municipal An-Nan Hospital, China Medical University, Tainan, Taiwan Department of Orthopedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan Department of Orthopedic Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan Department of Neurosurgery, Harrison Spinartus Hospital Chungdam, Seoul, Korea Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanThis video presents a case of L4–5 unstable spondylolisthesis treated with full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), emphasizing the GUARD (Glider Used as a Rotary Device) technique for nerve root protection. This innovative approach involves controlled rotation of the cage glider before cage insertion to minimize the risk of nerve root injury, a significant complication in Endo-TLIF procedures. The GUARD technique, validated in previous cadaveric studies, provides enhanced safety during cage insertion by protecting the nerve root. A 48-year-old woman with a 3-year history of progressive low back pain and bilateral lower extremity radiculopathy (right-sided predominance) was diagnosed with L4–5 unstable spondylolisthesis and spinal stenosis. After failure of conservative management, she underwent uniportal full-endoscopic facet-resecting transforaminal lumbar interbody fusion using the GUARD technique. Postoperatively, the patient experienced significant symptomatic improvement and resolution of radiculopathy, without any intraoperative nerve root injury or postoperative neurological deficits. This case demonstrates the effectiveness of the GUARD technique in reducing neurological complications and improving patient outcomes.http://e-neurospine.org/upload/pdf/ns-2449126-563.pdfendoscopesspinal fusionminimally invasive surgical proceduresspinal nerve root injurynerve root protectionsurgical technique |
| spellingShingle | Yu-Chia Hsu Hao-Chun Chuang Wei-Lun Chang Yuan-Fu Liu Chao-Jui Chang Yu-Meng Hsiao Yi-Hung Huang Keng-Chang Liu Chien-Min Chen Hyeun-Sung Kim Cheng-Li Lin Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique Neurospine endoscopes spinal fusion minimally invasive surgical procedures spinal nerve root injury nerve root protection surgical technique |
| title | Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique |
| title_full | Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique |
| title_fullStr | Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique |
| title_full_unstemmed | Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique |
| title_short | Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique |
| title_sort | innovative nerve root protection in full endoscopic facet resecting lumbar interbody fusion controlled cage glider rotation using the guard glider used as a rotary device technique |
| topic | endoscopes spinal fusion minimally invasive surgical procedures spinal nerve root injury nerve root protection surgical technique |
| url | http://e-neurospine.org/upload/pdf/ns-2449126-563.pdf |
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