AOSpine Consensus Paper on Nomenclature for Working-Channel Endoscopic Spinal Procedures

Christoph P Hofstetter; Yong Ahn; Gun Choi; J N A Gibson; S Ruetten; Yue Zhou; Zhen Zhou Li; Christoph J Siepe; Ralf Wagner; Jun-Ho Lee; Koichi Sairyo; Kyung Chul Choi; Chien-Min Chen; A E Telfeian; Xifeng Zhang; Arun Banhot; Pramod V Lokhande; N Prada; Jian Shen; F C Cortinas; N P Brooks; Peter Van Daele; Vit Kotheeranurak; Saqib Hasan; Gun Keorochana; Mohammed Assous; Roger Härtl; Jin-Sung Kim

doi:10.1177/2192568219887364

AOSpine Consensus Paper on Nomenclature for Working-Channel Endoscopic Spinal Procedures

Global Spine J. 2020 Apr;10(2 Suppl):111S-121S. doi: 10.1177/2192568219887364. Epub 2020 May 28.

Authors

Christoph P Hofstetter¹, Yong Ahn², Gun Choi³, J N A Gibson⁴, S Ruetten⁵, Yue Zhou⁶, Zhen Zhou Li⁷, Christoph J Siepe⁸, Ralf Wagner⁹, Jun-Ho Lee¹⁰, Koichi Sairyo¹¹, Kyung Chul Choi¹², Chien-Min Chen¹³, A E Telfeian¹⁴, Xifeng Zhang¹⁵, Arun Banhot¹⁶, Pramod V Lokhande¹⁷, N Prada¹⁸, Jian Shen¹⁹, F C Cortinas²⁰, N P Brooks²¹, Peter Van Daele²², Vit Kotheeranurak²³, Saqib Hasan²⁴, Gun Keorochana²⁴, Mohammed Assous²⁵, Roger Härtl²⁶, Jin-Sung Kim²⁷

Affiliations

¹ University of Washington, Seattle, WA, USA.
² Gachon University, Incheon, South Korea.
³ Wooridul Spine Hospital, Pohang, South Korea.
⁴ Spire Murrayfield Hospital, Edinburgh, UK.
⁵ Center for Spine Surgery and Pain Therapy, Center for Orthopedics and Traumatology of the St. Elisabeth Group-Catholic Hospital Rhein-Ruhr, St. Anna Hospital Herne/Marien Hospital Herne University Hospital of the Ruhr University of Bochum/Marien Hospital Witten, Herne, Germany.
⁶ Xinquiao Hospital, Third Military Medical University, Chongquing, China.
⁷ Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, China.
⁸ Schön Clinic Munich Harlaching, Munich, Germany.
⁹ Ligamenta Spine Center, Frankfurt am Main, Germany.
¹⁰ Kyung Hee University Medical Centre, Seoul, South Korea.
¹¹ The University of Tokushima, Tokushima, Japan.
¹² The Leon Wiltse Memorial Hospital, Anyang, South Korea.
¹³ Changhua Christian Hospital, Changhua, and Dayeh University, Changhua.
¹⁴ Rhode Island Hospital, The Warren Alpert Medical School of Brown, Providence, RI, USA.
¹⁵ The General Hospital of Chinese People's Liberation Army, Beijing, China.
¹⁶ Columbia Asia Hospital, Gurugram, Haryana, India.
¹⁷ SKN Medical College, Pune, India.
¹⁸ Foscal International Clinic, Floridablanca, Colombia.
¹⁹ Mohawk Valley Orthopedics, Amsterdam, NY, USA.
²⁰ Hospital Angeles Pedregal Camino Santa Teresa, Mexico City, Mexico.
²¹ University of Wisconsin, Maddison, WI, USA.
²² O.L.V. van Lourdes Ziekenhuis, Waregem, Belgium.
²³ Queen Savang Vadhana Memorial Hospital, Sriracha, Chonburi, Thailand.
²⁴ Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
²⁵ Razi Spine Clinic-Minimally Invasive Spine Surgery, Amman, Jordan.
²⁶ Weill Cornell Medical College, New York, NY, USA.
²⁷ St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.

Abstract

Study design: International consensus paper on a unified nomenclature for full-endoscopic spine surgery.

Objectives: Minimally invasive endoscopic spinal procedures have undergone rapid development during the past decade. Evolution of working-channel endoscopes and surgical instruments as well as innovation in surgical techniques have expanded the types of spinal pathology that can be addressed. However, there is in the literature a heterogeneous nomenclature defining approach corridors and procedures, and this lack of common language has hampered communication between endoscopic spine surgeons, patients, hospitals, and insurance providers.

Methods: The current report summarizes the nomenclature reported for working-channel endoscopic procedures that address cervical, thoracic, and lumbar spinal pathology.

Results: We propose a uniform system that defines the working-channel endoscope (full-endoscopic), approach corridor (anterior, posterior, interlaminar, transforaminal), spinal segment (cervical, thoracic, lumbar), and procedure performed (eg, discectomy, foraminotomy). We suggest the following nomenclature for the most common full-endoscopic procedures: posterior endoscopic cervical foraminotomy (PECF), transforaminal endoscopic thoracic discectomy (TETD), transforaminal endoscopic lumbar discectomy (TELD), transforaminal lumbar foraminotomy (TELF), interlaminar endoscopic lumbar discectomy (IELD), interlaminar endoscopic lateral recess decompression (IE-LRD), and lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD).

Conclusions: We believe that it is critical to delineate a consensus nomenclature to facilitate uniformity of working-channel endoscopic procedures within academic scholarship. This will hopefully facilitate development, standardization of procedures, teaching, and widespread acceptance of full-endoscopic spinal procedures.

Keywords: consensus; full-endoscopic spine surgery; interlaminar; lateral recess decompression; minimally invasive spinal surgery; nomenclature; transforaminal; working-channel endoscope.