Minireviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2017; 8(12): 874-880
Published online Dec 18, 2017. doi: 10.5312/wjo.v8.i12.874
Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique: Pitfalls that a beginner should avoid
Stylianos Kapetanakis, Grigorios Gkasdaris, Antonios G Angoules, Panagiotis Givissis
Stylianos Kapetanakis, Grigorios Gkasdaris, Spine Department and Deformities, Interbalkan European Medical Center, Thessaloniki 55535, Greece
Antonios G Angoules, Department of Medical Laboratories, Technological Educational Institute of Athens, Athens 12243, Greece
Panagiotis Givissis, First Orthopaedic Department of “Aristotle University of Thessaloniki”, “Papanikolaou” Hospital, Exohi, Thessaloniki 57010, Greece
Author contributions: All authors equally contributed to this paper with conception and design of the study; all authors approved the final version of the article.
Conflict-of-interest statement: The authors of this manuscript declare that they have no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Antonios G Angoules, MD, PhD, Department of Medical Laboratories, Technological Educational Institute of Athens, 28 Agiou Spiridonos St, Athens 12243, Greece. angoules@teiath.gr
Telephone: +30-6-977011617
Received: July 17, 2017
Peer-review started: July 20, 2017
First decision: September 4, 2017
Revised: September 11, 2017
Accepted: October 17, 2017
Article in press: October 17, 2017
Published online: December 18, 2017
Processing time: 152 Days and 15.4 Hours
Abstract

Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions. In this review, pitfalls that a novice surgeon has to be mindful of, are reported and analyzed.

Keywords: Transforaminal Percutaneous Endoscopic Discectomy; Transforaminal Endoscopic Spine System; Lumbar disk herniation; Pitfalls; Spine surgery

Core tip: Transforaminal Percutaneous Endoscopic Discectomy (TPED) is an evolving minimally invasive technique that has been proven to be safe and effective in treating symptomatic lumbar disc herniation (LDH). However, this relatively new therapeutic approach requires special training and expertise so as to evade complications that may endanger the safety of the patient. In this review, current concepts regarding challenging indications and contraindications of this novel technique are analyzed focusing on several conditions and pitfalls that a beginner spine surgeon should avoid when treating LDH using TPED with Transforaminal Endoscopic Spine System technique, so as to eliminate possible risks and thus improve outcomes.