Lumbar spinal decompression is performed with a posterior interlaminar approach. A skin incision of app. 8-9mm is made in the interlaminar window. A conical blunt dilator is introduced in the interlaminar window. A working cannula is introduced over the dilator with the beveled opening of the working cannula directed medially towards the ligamentum flavum. Sequential trimming of the Inferior articular process- Superior Lamina, Superior articular process – Inferior lamina is performed with motorised drills & Kerrison rongeurs.
After completion of bony decompression, Ligamentum flavum is removed ipsilaterally and centrally within the bony window created by trimming the facet & lamina, Complete decompression of the thecae sac & ipsilateral traversing root is performed from tip if the Superior articular process to 1/2 of caudal pedicle. For contralateral decompression the base of the spinous process is trimmed with the motorised drill and contralateral bony & soft tissue decompression performed with thinning of the lamina, Trimming the Inferior articular process, Superior articular process, cranial & Caudal lamina dorsal to the thecal sac. Ligamentum flavum is removed to decompress the contralateral traversing root. The entire procedure is performed under endoscopic visual control using the MaxMoreSpine 5.5 mm endoscope.
Content starter kit:
| Art | Description | Qty |
| 1002-TS 004 | TOM Endo Stick 5.5 mm working channel | 1 |
| 1001-DC 010 | Dilator 7.9 mm | 1 |
| 1001-ES 19 | Working Sleeve 112 mm / 8.5 mm ID | 1 |
| 1001-SK 001/H | Universal Coated Kerrison Punch Handle | 4 |
| 1001-SK 002/S | Coated Kerrison Punch Shaft, 240 mm / Ø 5 mm down to 2 mm, 40° | 2 |
| 1001-SK 003/S | Coated Kerrison Punch Shaft, 240 mm / Ø 5 mm down to 3 mm, 40° | 2 |
| 1001-SK 004/S | Coated Kerrison Punch Shaft, 240 mm / Ø 5 mm down to 4 mm, 40° | 2 |
| 1001-SK 005/S | Coated Kerrison Punch Shaft, 240 mm / Ø 5 mm down to 5 mm, 40° | 2 |
| 1001-DI 01 | Dissector ø 3.5mm / 245 mm | 1 |
| 1001-TH 001 | Tactile Hook – Small Hook | 1 |
| 1001-TH 002 | Tactile Ball Hook – Big Hook | 1 |
| 1001-SF 001 | Stenosis Grasping forceps 3.0 mm / 250 mm | 1 |
| 1001-SF 002 | Stenosis Grasping forceps 4.0 mm / 250 mm | 1 |
| 1001-IS 005 | Instrument Container Stenosis | 1 |
| 1001-IS 006 | Instrument Tray Stenosis | 1 |
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Neurological safety during transforaminal endoscopic surgery of the spine is of paramount importance. In order not to irritate neurological structures close to the foramen and to ensure safe access to the spinal canal, the caudal part of the foramen is widened incrementally with specially designed, patented manual bone drills. To approach the spinal canal & disc through the foramen a posterolateral approach to the intervertebral foramen is used. The needle is guided to the superior articular process / lateral facet and infiltrated with local anaesthetic. A guide wire is inserted through the needle and the needle removed. Soft tissue is dilatation is performed with serial dilators. The Tom Shidi Needle (Bone needle) is introduced over the guide wire & docked on the superior articular facet ventrally and gently tapped with mallet till it reaches in line with the medial border of the pedicle to the desired location targeting the herniation. The SAP is sequentially drilled with the patented manual bone drills till the desired size is achieved & foramen enlarged. A conical dilator is tapped to the desired location and working sleeve introduced over the dilator.
The Endoscope is introduced through the working sleeve. With resection instruments, the herniated disc material is removed under direct vision. Confirmation of decompression & free neurological structures are confirmed under direct vision.
Controlled, exact and reliable delivery!
NovaBone MIS delivers the only synthetic graft that signals and recruits osteoprogenitor cells while controlling the cell cycle to favor proliferation and differentiation of cells that generate new bone. NovaBone demonstrated equivalent rates of bone growth when compared to autograf
NovaBone Putty is a versatile bone graft substitute that is ready to use out of the package with exceptional handling characteristics that will save time and improve placement.
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