Transforaminal Endoscopic Spine Surgery - An evolving concept
Malcolm Pestonji
MGM University of Health Sciences, India
: J Spine Neurosurg
Abstract
Background • From the Era of Dr. Parvez Kambin and Dr. Hijikata • To the targeted removal of herniated fragments by Anthony Yeung and Dr. Satishchandra Gore • The scope and role of Transforaminal Endoscopic Spine Surgery has evolved in concept and application Scope: True Transforaminal insertion of expandable and non-expandable cages under local anesthesia (completely facet sparing mode) assisted by minimally invasive posterior fixation under sensory epidural block for indications of instability such as Degenerative Lysthesis / Retro Lysthesis / Spondylolisthesis. Instrumentation used: The author used the Karl Storz Gore Endoscopy System with added self-designed dilator systems and shavers to achieve satisfactory results. Results: Over a one-year follow-up of patients has resulted in 80 % patients with excellent to good results. One patient had unsatisfactory results with dysesthesia and lingering root pain. One patient in transforaminal cage placement had transient L4 root injury with 3 months to recover from motor weakness grade three and needed bracing. Conclusion: Transforaminal Endoscopic Spine Surgery has Evolved beyond its normal confines with very satisfying results in its newer applications of lat canal stenosis, instability. Transforaminal insertion of a cage under local anesthesia is a paradigm shift in the stabilization of an unstable spine.
Biography
Malcolm Pestonji has authored a manual for the procedures he follows, called “Operative Manual Transforaminal Stitchless Surgery under Local Anaesthesia for Lumbar Spine”. It is the first such book describing the Transforaminal Endoscopic Spine Technique in detail. He heads a core team of visiting faculty on behalf of the Mission Spine Foundation as course director and principal-in-charge for setting up a centre of excellence in endoscopic spine training at MGM University in Navi Mumbai. This is the first such official university-approved course in the world. He also conducts numerous mentorship programs where surgeons learn the art of Endoscopic Spine Surgery under his watchful eye. Malcolm Pestonji has been a speaker and moderator at numerous conferences, including the 7th ACMISST & 18th KOMISS 2019 held in Seoul, South Korea, and the 6th Annual Conference of Neurosurgery Center El Galaa Military Medical Complex and Military Medical Academy in Cairo, Egypt to name a few.
