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Background: This study aims to evaluate patient perceptions of the outcomes following awake transforaminal endoscopic lumbar decompression surgery for treating degenerative spine diseases.
Methods: Over a 1-year period from 2022 to 2023, awake transforaminal endoscopic spine surgeries were performed on 183 patients using local anesthesia and sedation, allowing patients to communicate with the surgical team throughout the procedure. A follow-up app-based survey was sent to these patients to assess their perceptions and outcomes related to the surgery.
Results: Out of 183 recipients, 102 patients completed the survey. At the 1-year follow-up, 89.2% of the respondents reported better outcomes in comparison to traditional spine surgeries, and 98% expressed willingness to recommend the procedure to others with similar conditions.
Conclusions: The findings demonstrate notable advancements in minimally invasive spine surgery, with awake transforaminal endoscopic decompression showing high satisfaction rates tied closely to meeting patient expectations. The study also identifies areas for improvement, particularly in managing postoperative pain and aligning patients' expectations with clinical results.
Clinical Relevance: Effective preoperative communication and consistent pain management practices are critical in enhancing patient satisfaction and postoperative recovery, along with the integration of conservative treatments such as physical therapy and acupuncture to maximize surgical outcomes.
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http://dx.doi.org/10.14444/8763 | DOI Listing |
Int J Spine Surg
September 2025
Division Personalized Pain Research and Education, Center for Advanced Spine Care of Southern Arizona, Tucson, AZ, USA.
Background: This study aims to evaluate patient perceptions of the outcomes following awake transforaminal endoscopic lumbar decompression surgery for treating degenerative spine diseases.
Methods: Over a 1-year period from 2022 to 2023, awake transforaminal endoscopic spine surgeries were performed on 183 patients using local anesthesia and sedation, allowing patients to communicate with the surgical team throughout the procedure. A follow-up app-based survey was sent to these patients to assess their perceptions and outcomes related to the surgery.
Spine (Phila Pa 1976)
April 2025
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Jacksonville, FL.
Study Design: Literature review and institutional analysis.
Objective: This review examines the potential advantages of awake spinal surgery under neuroaxial anesthesia in minimizing positioning-related complications compared with traditional general anesthesia.
Summary Of Background Data: Spinal surgeries performed in the prone position under general anesthesia are associated with perioperative complications, such as ocular injury and vision loss, nerve damage, and pressure ulcers.
Clin Neurol Neurosurg
April 2025
Vail-Summit Orthopaedics and Neurosurgery, 180 S Frontage Rd W, Suite 2700, Vail, CO 81657, United States.
Objectives: To implement an integrated anesthesia and surgery protocol of improved postoperative pain control to facilitate transitioning of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) from a hospital to an ambulatory surgery center setting by lowering postoperative (in-facility) narcotic consumption and length of stay (LOS) transitioning from general to awake spinal anesthesia.
Methods: A retrospective cohort study of 180 patients who received awake or general anesthesia (GA) MI-TLIF from 2017 to 2023.
Results: Among 180 MI-TLIF patients, 101 (56 %) received awake protocol and 79 (44 %) received general anesthesia.
Neurosurgery
March 2025
Department of Neurological Surgery, School of Medicine, University of California, San Francisco, San Francisco, California, USA.
The transforaminal lumbar interbody fusion (TLIF) technique, pioneered by Harms and Rolinger in 1982 and further refined in the early 2000s by Rosenberg and Mummaneni and later by Foley and Lefkowitz, uses Kambin triangle to access the disc space, thecal sac, and nerve roots. The minimally invasive surgery (MIS) approach to TLIF minimizes soft tissue disruption and spinal segment destabilization, offering benefits such as reduced operative times, blood loss, complications, and postoperative opiate use, with comparable fusion rates to open techniques. Despite these advantages, MIS interbody selection poses challenges, with the MIS TLIF preferred for L4-5 fusions when lordosis restoration is not needed.
View Article and Find Full Text PDFWorld Neurosurg
November 2024
Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA. Electronic address: