Article
SpineGate – multipurpose retractor system for endoscopic and microsurgical spinal interventions: Clinical results
SpineGate – Multifunktionelles Sperrersystem für endoskopische und mikrochirurgische spinale Eingriffe: Klinische Ergebnisse
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Published: | May 8, 2006 |
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Objective: Retractors play an important role in surgery, especially using endoscopic techniques like endoscopic discectomy. In 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. The authors describe the technical aspects of a newly designed circular retractor system (SpineGateTM, Geister Medizintechnik, Tuttlingen, Germany) and present first clinical results in a series of 50 consecutive patients.
Methods: The system consists of a circular base plate and several valves with a varying length The variable fixation of the valves within the base plate allows a continuously adjustable working space. Up to seven valves from different directions in the 360° geometry of the base plate can be used. The individually designed 90° offset fibre optic endoscope (Schölly Fiberoptic, Denzlingen, Germany) can also be variably fixed within the base plate. All components of the retractor system are made of titanium. The endoscope and the retractor system are autoclavable. 49 patients with herniated lumbar discs (HLD) and one patient with a herniated cervical disc (HCD) were operated upon. Levels operated included L4/5 (n=19), L5/S1 (n=30) and C6/7 (n=1). Clinical outcomes were assessed using the modified MacNab criteria with an average 6-month follow-up after surgery.
Results: The retractor was successfully used in all cases without any technical difficulties. In four cases at the beginning of the series we had to switch from endoscopic to microscopic technique without changing the retractor. All patients experienced good to excellent relief of their preoperative symptoms and were discharged home on the fourth postoperative day.
Conclusions: Our clinical results show the safety and efficacy of this system in the neurosurgical treatment of disc disease in carefully selected patients.