Intraoperative Computed Tomography Navigational Assistance for Transforaminal Endoscopic Decompression of Heterotopic Foraminal Bone Formation After Oblique Lumbar Interbody Fusion

• Published in: World neurosurgery Vol. 115; pp. 29 - 34
• Main Authors: Oyelese, Adetokunbo, Telfeian, Albert E., Gokaslan, Ziya L., Kosztowski, Thomas A., Choi, David, Fridley, Jared, Galgano, Michael
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2018
• Subjects: CT-guided navigation; Decompression, Surgical - methods; Endoscopes; Endoscopic spine surgery; Heterotopic bone formation; Humans; Lumbar Vertebrae - surgery; Lumbosacral Region - surgery; Male; Middle Aged; Minimally invasive; Minimally Invasive Surgical Procedures - methods; Neurosurgical Procedures - methods; OLIF; Spinal Fusion - methods; Transforaminal; CT; Minimally invasive; Transforaminal; Endoscopic spine surgery; Heterotopic bone formation; CT-guided navigation; OLIF
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2018.03.188

Transforaminal endoscopic spine surgery is an emerging technique in spine surgery, but it offers 2 distinct challenges to spine surgeons looking to adopt it: 1) targeting spine pathology and 2) understanding the endoscopic anatomy visualized through the endoscope. Intraoperative computed tomography (CT)-guided navigation is also an emerging technique in spine surgery that is becoming widely adopted for its benefits in assisting surgeons in localizing pathology and guided spine instrumentation placement. In this technical note, we describe a technique that uses intraoperative CT-guided navigation concomitantly with a transforaminal endoscopic approach to decompress a L4-L5 foraminal heterotopic bone formation after an oblique lumbar interbody fusion. The addition of intraoperative CT-guided navigation proved beneficial in targeting the pathology during the procedure and ensuring that the pathology was resolved by offering postoperative CT visualization of the decompressed neural foramen.
•Foraminal compromise is a possible complication of OLIF.•We describe a new technique for treating heterotopic foraminal bone formation.•CT-guided endoscopic decompression is presented for transforaminal decompression.