Chang Hsuan-Kan, Kolcun John Paul G, Chang Peng-Yuan, Wang Michael Y
Department of Neurological Surgery, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Oper Neurosurg (Hagerstown). 2019 Apr 1;16(4):519. doi: 10.1093/ons/opy187.
This video demonstrates the awake endoscopic minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF) used in our institution's developing Enhanced Recovery After Surgery program. This technique relies on 6 key components, including (1) conscious sedation, (2) endoscopic visualization, (3) long-acting local anesthesia, (4) an expandable interbody device, (5) osteobiologics, and (6) percutaneous instrumentation. In joining these technologies, this procedure embodies the principles of minimally invasive surgery while achieving excellent clinical outcomes. We have previously described this procedure in detail, as well as its impact at our institution, including significant reductions in operative time, blood loss, postoperative length of stay, and hospital costs. The procedure depicted in this video involves the off-label use of bone morphogenetic protein-2 and the Spineology Optimesh allograft containment device. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The patient gave direct consent for the use of the video footage and associated information from this surgery for the making and publication of this surgical video.
本视频展示了我院在开展的术后加速康复计划中所采用的清醒内镜下微创经椎间孔腰椎椎间融合术（MIS-TLIF）。该技术依赖于6个关键组成部分，包括（1）清醒镇静，（2）内镜可视化，（3）长效局部麻醉，（4）可扩张椎间融合器，（5）骨生物制剂，以及（6）经皮器械。通过整合这些技术，该手术在实现卓越临床效果的同时，体现了微创手术的原则。我们之前已详细描述过该手术及其在我院所产生的影响，包括手术时间、失血量、术后住院时间和住院费用的显著减少。本视频中所展示的手术涉及骨形态发生蛋白-2和Spineology Optimesh同种异体骨容纳装置的非标签使用。在涉及人类受试者的研究中所进行的所有手术均符合机构和/或国家研究委员会的伦理标准，以及1964年《赫尔辛基宣言》及其后续修订版或类似的伦理标准。患者已直接同意使用该手术的视频片段及相关信息用于制作和发布本手术视频。
