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Ohara et al. Mini-invasive Surg 2017;1:74-80 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.08
www.misjournal.net
Topic: Percutaneous endoscopic system for spinal diseases Open Access

Percutaneous endoscopic lumbar laminectomy

Yukoh Ohara , Sumito Shimizu , Junichi Mizuno
2
1
1
1 Center for Minimally Invasive Spinal Surgery, ShinYurigaoka General Hospital, Kawasaki, Kanagawa 215-0026, Japan.
2 Spine and Spinal Cord Center, Omigawa General Hospital, Katori-shi, Chiba 289-0332, Japan.
Correspondence to: Dr. Yukoh Ohara, Center for Minimally Invasive Spinal Surgery, ShinYurigaoka General Hospital, 255 Furusawa Asao-ku,
Kawasaki, Kanagawa 215-0026, Japan. E-mail: yukoh@juntendo.ac.jp

How to cite this article: Ohara Y, Shimizu S, Mizuno J. Percutaneous endoscopic lumbar laminectomy. Mini-invasive Surg 2017;1:74-80.
ABSTRACT
Article history: Aim: Percutaneous endoscopic lumbar laminectomy or laminotomy (PELL) is a minimally
Received: 05-03-2017 invasive surgical technique to treat lumbar canal stenosis. The procedure is undertaken using
Accepted: 20-03-2017 a single port endoscope, as with percutaneous endoscopic lumbar discectomy (PED). PED has
Published: 30-06-2017 become popular with spinal surgeons in Japan as a suitable surgery for lumbar disc herniation
patients. Because PED has the powerful advantage of structural preservation, it allows for
Key words: short hospital stays and early recovery of the patient. PELL and PED are conceptually very
Percutaneous endoscopic lumbar similar, in that they are both minimally invasive. PELL is not as popular as PED, however.
laminectomy, The aim of the current study was to explore the reasons why. Methods: The current study
lumbar canal stenosis, reports the early experiences of surgeons at this institution in using the PELL technique, and
single port endoscope its limitations. Results: The goal of PELL is total flavectomy and decompression of the bony
structure. Currently, there are difficulties and limitations in achieving decompression using
PELL with small tools. Conclusion: PELL requires much more skill than PED and the learning
curve is not steep. PELL is minimally invasive for the patient, but further developments of the
endoscope or procedures are required to achieve widespread use.

INTRODUCTION decompression for lumbar canal stenosis (LCS),
in a procedure referred to as percutaneous lumbar
Percutaneous endoscopic surgery for spinal laminectomy (or laminotomy) (PELL). However, no
degenerative diseases is carried out using a special studies concerning this method using a single-port
single-port endoscope under irrigation, making endoscope have yet been published. This report
the invasiveness of this surgery extremely low. [1-5] describes the PELL procedure and its limitations,
Percutaneous endoscopic lumbar discectomy (PED) based on the initial clinical experiences of surgeons at
has been extensively reported, and the development this institution.
of drills and bipolar coagulators has broadened
its application. [6-10] In particular, the ability to use METHODS
drills has expanded the surgical indications for the
interlaminar approach (PED-IL) to include patients with Surgical indication
an insufficiently wide interlaminar space and those Currently, PELL is only performed in this institution
with concomitant osseous stenosis. [11,12] Attempts to treat LCS at a single vertebral level. In the case
have been made to use PED-IL to perform posterior of multiple stenosis, after obtaining consent from the

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