Clinical applications of the tubular retractor on spinal disorders

Abstract

Tubular retractor system as a minimally invasive surgery (MIS) technique has many advantages over other conventional MIS techniques. It offers direct visualization of the operative field, anatomical familiarity to spine surgeons, and minimizing tissue trauma. With technical advancement, many spinal pathologies are being treated using this system. Namely, herniated discs, lumbar and cervical stenosis, synovial cysts, lumbar instability, trauma, and even some intraspinal tumors have all been treated through tubular retractor system. Flexible arm and easy change of the tube direction are particularly useful in contralateral spinal decompression from an ipsilateral approach. Careful attention to surgical technique through narrow space will ensure that complications are minimized and will provide improved outcomes. However, understanding detailed anatomies and keeping precise surgical orientation are essential for this technique. Authors present the technical feasibility and initial results of use a tubular retractor system as a minimally invasive technique for variaties of spinal disorders with a review of literature.

Keywords: Microendoscopic discectomy; Minimally invasive surgery; Spinal disorders; Tubular retractor.

Fig. 1

METRx tubular retractor system.

Fig. 2

Root retractor can be effectively used for muscle retraction laterally.

Fig. 3

Bilateral screws insertion can be possible through single midline incision.

Fig. 4

Electrode lead implantation in the epidural space.