Minim Invasive Neurosurg 2004; 47(3): 190-195
DOI: 10.1055/s-2004-818487
Technical Note
© Georg Thieme Verlag Stuttgart · New York

Novel Retractor for Endoscopic and Microsurgical Spinal Interventions

D.  Freudenstein1 , F.  Duffner1 , T.  Bauer1
  • 1Department for Neurosurgery, University Hospital, Eberhard-Karls University Tübingen, Tübingen, Germany
Further Information

Publication History

Publication Date:
18 July 2005 (online)

Abstract

Retractors play an important role in surgery, especially using endoscopic techniques like microendoscopic discectomy. As a consequence of the minimally invasive approach the working space is frequently very restricted. All currently available systems still use tubular retractors with limitations regarding flexibility, stability and accessible working space. This paper discusses the technical aspects of a newly designed circular retractor system for endoscopic and microsurgical spinal interventions (SpineGateTM) and presents first clinical results in a series of 20 consecutive patients. The autoclavable system consists of a circular base plate and several valves varying in length. The variable fixation of the valves from different directions within the 360° geometry of the base plate allows a continuously adjustable working space, depending on the individual anatomy. An additional fixation device is not necessary. The retractor is suitable for microendoscopic and microsurgical techniques. It is easy and safe to handle. The retractor system was successfully used in all cases without complications or instrumental malfunctions. All patients experienced good to excellent relief of their preoperative symptoms.

References

  • 1 Pool J L. Direct visualization of dorsal nerve roots of the cauda equina by means of a myeloscope.  Arch Neurol Psychiatr. 1938;  39 1308-1312
  • 2 Pool J L. Myeloscopy: Intraspinal endoscopy.  Surgery. 1942;  11 169-182
  • 3 Mayer H M, Brock M. Percutaneous endoscopic discectomy: Surgical technique and preliminary results compared to microsurgical discectomy.  J Neurosurg. 1993;  78 216-225
  • 4 Seibel R M, Groenemeyer D H. Technique for CT guided microendoscopic dissection of the spine.  Endosc Surg Allied TechnoI. 1994;  2 226-230
  • 5 DeAntoni O J, Claro M L, Poehling G G, Hughes S S. Translaminar lumbar epidural endoscopy: technique and clinical results.  J South Orthop Assoc. 1998;  7 6-12
  • 6 Smith M M, Foley K T. MED. Microendoscopic discectomy (MED): Surgical technique and initial clinical results. Conference Proceedings. 13th Annual Meeting of the Joint Section of Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and Congress of Neurological Surgeons,. 1997
  • 7 Foley K T, Smith M M. Microendoscopic discectomy.  Tech Neurosurg. 1997;  3 301-307
  • 8 Smith M M, Foley K T. MED: The first 100 cases. Presented at the Annual Meeting of the Congress of Neurological Surgeons. 1998
  • 9 Perez-Cruet M J, Foley K T, Issacs R E, Rice-Wyllie L, Wellington R, Smith M M, Fessler R G. Microendoscopic lumbar discectomy. Technical note.  Neurosurgery. 2002;  51 (Suppl 2) 129-136
  • 10 Adamson T E. Microendoscopic posterior cervical laminoforaminotomy for unilateral radiculopathy: results of a new technique in 100 cases.  J Neurosurg. 2001;  95 (Suppl 1) 51-57
  • 11 Brayda-Bruno M, Cinella P. Posterior endoscopic discectomy (and other procedures).  Eur Spine J. 2000;  9 (Suppl) 24-29

Dirk Freudenstein, M. D. 

Department for Neurosurgery · University Hospital · Eberhard-Karls University Tübingen

Hoppe-Seyler-Straße 3

72076 Tübingen

Germany

Phone: +49-7071-298-6742 ·

Fax: +49-7071-295-245

Email: dkfreude@med.uni-tuebingen.de

    >