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Biomedical subjects

John C Chiu

Publications and source records attributed to John C Chiu.

6 recordsLinked to original sources

Endoscopic assisted lumbar microdecompressive spinal surgery with a new SMART endoscopic spine system.

In response to the rapid development and demand of outpatient endoscopic minimally invasive lumbar surgical technique, the SMART endoscopic spine system was developed for neurodecompression. This lumbar spine surgery is performed with a small skin incision, dilatation surgical technology, and an endoscopic-assisted spinal surgical system with progressive serial tubular retractors providing superior lighting and better visualization of the operative field for performing minimally invasive spinal surgery (MISS). The SMART system incorporates the advantages of posterior paramedian endoscopic assisted microdecompressive surgical spinal system and posterolateral endoscopic lumbar system. This versatile SMART endoscopic spine system with various sized working channels provides a generous and optimal access for endoscopic MISS of microdecompression of herniated lumbar disc, degenerative spinal disease, spinal stenosis, and removal of intraspinal lesions as well as creating an access for spinal arthroplasty and spinal fixation. With the unique features of the SMART system, the surgeon can take advantage of microscopic, endoscopic, or direct vision for microdecompressive spinal surgery, bridging endoscopic and conventional spinal surgery. It appears easy, safe, and efficacious. This less traumatic and easier outpatient MISS treatment leads to excellent result speedier recovery, and significant economic savings. The SMART endoscopic spine system, surgical indications, operative techniques, and the potential complications and their avoidance are described and discussed herein.

Decompression, Surgical↗

Interspinous process decompression (IPD) system (X-STOP) for the treatment of lumbar spinal stenosis.

With increased life expectancy and an aging population, many patients suffering from progressive lumbar spinal stenosis with symptomatic neurogenic intermittent claudication (NIC) have been limited to a choice between nonsurgical therapies or a more traumatic decompressive surgical procedure, with or without lumbar fusion. The interspinous process decompression (IPD) system, the X-STOP implant, was developed to provide a minimally invasive alternative therapeutic treatment of lumbar spinal stenosis. The X-STOP IPD system, surgical indications, operative techniques, and the potential complications and their avoidance are described and discussed herein.

Decompression, Surgical↗

Percutaneous vertebral augmentation and reconstruction with an intravertebral mesh and morcelized bone graft.

Percutaneous vertebral augmentation (VA) and reconstruction with intravertebral polyethylene mesh sac (OptiMesh) and morcelized bone graft provided a minimally invasive efficacious and controlled delivery mechanism to stabilize and treat painful osteoporotic, traumatic and neoplastic vertebral compression fractures (VCFs), as well as avoided serious complications from Polymethylmethacrylate (PMMA) of Vertebroplasty and Kyphoplasty. Osteoconductive and osteoinductive and can be used to create biologic vertebral reconstruction. The adjacent vertebra integrity should be more protected by the construct with a similar elasticity and physical characteristics of the morcelized bone, more matched to that of adjacent bone than PMMA. The indications and surgical techniques are described herein.

Biocompatible Materials↗

Junctional disc herniation syndrome in post spinal fusion treated with endoscopic spine surgery.

Fusions of the cervical and lumbar spine are often followed within months or several years by protrusion of discs at the adjacent level or levels. Biomechanical alterations and mobility lost at the fused levels are thought to be transferring the stress to the adjacent segments or discs, which results in accelerated degeneration of the discs and causes disc protrusion. This post-spinal fusion "junctional disc herniation syndrome" (JDHS), or the post-spinal fusion "adjacent segment disease (ASD)" can occur from 15% to 52% of post-spinal fusion, in both superior and/or inferior adjacent levels. The ways in which endoscopic minimally invasive spinal discectomy procedure can be used to treat this JDHS and preserve spinal segmental motion are discussed herein. Also, case illustrations are presented.

Adult↗

Evolving transforaminal endoscopic microdecompression for herniated lumbar discs and spinal stenosis.

The objective of this chapter was to demonstrate evolving transforaminal endoscopic microdecompression for herniated lumbar discs and spinal stenosis, and to become accomplished with endoscopic micro spinal instruments and laser application. Since 1993, 2000 patients with 3421 herniated lumbar discs were diagnosed with symptomatic lumbar single and multiple herniated intervertebral discs. Progressive series of different diameters endoscopic-assisted tubular retractors, with appropriate-sized dilators and more aggressive saw-toothed trephines, and laser were used to perform transforaminal endoscopic micro-decompression, in addition to the posterior-lateral foraminoscope and endoscopic-assisted spinal operating systems. No postoperative mortalities occurred, and the morbidity rate was less than 1%, in the 2000 patients. For a single level, 94% of the patients had good or excellent results; 6% had some residual symptoms although improved overall. Transforaminal endoscopic laser microdecompression can effectively decompress herniated lumbar discs and spinal stenosis, when foraminoplasty is performed, which provides a safe and effective modality to achieve results in effective spinal decompression, preserves spinal motion, and creates a channel for spinal arthroplasty.

Aged↗

Percutaneous microdecompressive endoscopic thoracic discectomy for herniated thoracic discs.

Spinal surgeons have long sought to find a procedure of choice by which to treat thoracic disc herniations. The threat of cord injury has stimulated many attempted approaches including posterior laminectomy (abandoned currently as too likely to result in neurologic loss), costotransversectomy, trans-thoracic trans-pleural, postero-lateral, trans-pedicular and, more recently, transthoracic endoscopic. Commonly, surgery is not contemplated unless significant cord compression and neurologic deficit is present.

Adult↗