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Video: Platzierung eines endoskopisch assistierten EndoLIF Cages in der von Dr. Wagner entwickelten Technik.


Full Endoscopic Surgery for Thoracic Pathology

In der Fachpublikation "BioMed Research International" beschreibt Dr. Ralf Wagner mit seinen internationalen Kollegen Junseok Bae, Sang-Ho Lee, Jian Shen und Albert E. Telfeian, den detaillierten OP-Ablauf sowie Tipps und Tricks bei minimal-invasiven chirurgischen Bandscheibenoperationen.

Artikel im Volltext auf englisch:

Abstract: Thoracic disc herniation and stenosis are relatively rare, and various symptoms make them difficult to diagnose. Due to the complexity of neural and vascular structure, surgical treatment of thoracic pathology is challenging. Endoscopic spine surgery is an emerging minimally invasive surgical option. Based on wide experience on the cervical and lumbar spine, an endoscopic approach for the thoracic pathology can be performed beyond the learning curve. Transforaminal approach for thoracic disc herniation, endoscopic unilateral approach, and bilateral decompression for thoracic stenosis have been reported as favorable and safe surgical options. In the present study, the authors described the detailed surgical procedure as well as tips and tricks.

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Spinal endoscopy: evidence, techniques, global trends, and future projections

Wissenschaftliche Übersicht und Hintergrundbericht aus 2021 über die neusten Techniken und Trends in der Wirbelsäulenendoskopie.

Artikel im Volltext auf englisch:

Summary: The utilization of indirect visualization during procedures has been increasingly replacing traditional forms of direct visualization across many different surgical specialties. The adoption of arthroscopy, using small cameras placed inside joints, has transformed musculoskeletal care over the last several decades, allowing surgeons to provide the same anatomic solutions with less tissue dissection, resulting in lower requirements for inpatient care, reduced costs, and expedited recovery. For a variety of reasons, spine surgery has lagged behind other specialties in the adoption of indirect visualization. Nonetheless, patient demand for less invasive spine procedures and surgeon drive to provide these solutions and improve care quality has driven global adoption of spinal endoscopy. There are numerous endoscopic platforms and techniques currently utilized, and these systems are rapidly evolving. Additionally, the variance in technology and health system incentives across the globe has generated tremendous regional heterogeneity in the utilization of spinal endoscopic procedures. We present a consolidated review, including the background, evidence, techniques, and trends in spinal endoscopy, so that clinicians can gain a deeper understanding of this rapidly evolving domain of spinal healthcare.

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Erstmalige endoskopische Bandscheibenoperation in Teilnarkose in der Berit Klinik von Dr. Wagner durchgeführt

Einen Bandscheibenvorfall an der Lendenwirbelsäule operativ zu behandeln, stehen je nach Art und Schwere der Verletzung verschiedene Verfahren zur Verfügung. Die Operation wird dabei in der Regel unter Vollnarkose durchgeführt. mehr ...


Wiss. Artikel von Dr. Wagner in "Operative Neurosurgery"

Artikel von Dr. Wagner und Kollegen zum Thema Operationstechniken mit dem Titel: "The Endoscopic Trans-Superior Articular Process. Approach: A Novel Minimally Invasive Surgical Corridor to the Lateral Recess."

Artikel online abrufbar unter

Dr. Wagner im Triathlon-Magazin

In der Printausgabe des Sportmagazins "Tritime" berichtet Dr. Wagner auf Seite 60 und 61 über konservative und operative Behandlungsmethoden bei Bandscheibenvorfällen in Hinblick auf Ausdauersportler und Triathleten.


Veröffentlichungen von Dr. Wagner zum Thema Endoscopic Spine Surgery

Auf der Webseite von kann man einfach nach wissenschaftlichen Veröffentlichungen recherchieren. So auch die Arbeiten von Dr. Wagner zum Thema Endoscopic Spine Surgery

Endoscopic Spine Surgery: Distance Patients Will Travel for Minimally Invasive Spine Surgery.

Telfeian AE, Iprenburg M, Wagner R.Pain Physician. 2017 Jan-Feb;20(1):E145-E149.PMID: 28072806 Free article.

Endoscopic spine surgeons around the world have noted how far patients will travel to undergo this minimally invasive spine surgery, but the actual distance patients travel has never been investigated. ...METHODS: Patient demographic data was analyzed …

Patient radiation exposure during transforaminal lumbar endoscopic spine surgery: a prospective study.

Iprenburg M, Wagner R, Godschalx A, Telfeian AE.Neurosurg Focus. 2016 Feb;40(2):E7. doi: 10.3171/2015.11.FOCUS15485.PMID: 26828888

METHODS Radiation exposure was monitored in 151 consecutive patients undergoing single-level transforaminal endoscopic lumbar discectomy procedures. ...One caveat is that both the surgeon and the patient are likely to be exposed to higher doses of radiation during a …

Transpedicular Lumbar Endoscopic Surgery for Highly Migrated Disk Extrusions: Preliminary Series and Surgical Technique.

Krzok G, Telfeian AE, Wagner R, Iprenburg M.World Neurosurg. 2016 Nov;95:299-303. doi: 10.1016/j.wneu.2016.08.018. Epub 2016 Aug 16.PMID: 27542563

OBJECTIVE: Endoscopic surgery for highly migrated lumbar disk extrusions is a challenge even for spine surgeons who are familiar with using endoscopic techniques. Because of the anatomic constraints involved in transforaminal access in endoscopic …

An endoscopic surgical technique for treating radiculopathy secondary to S1 nerve compression from a pedicle screw: technical note.

Wagner R, Telfeian AE.J Spine Surg. 2018 Dec;4(4):787-791. doi: 10.21037/jss.2018.11.03.PMID: 30714011 Free PMC article. Review.

Pedicle screw instrumentation is a widely used technique for fixating the spine in fusion surgery. One of the complications associated with pedicle screw placement is when a screw breaches the pedicle medially and causes the patient radicular pain or numbness or wea …

Transforaminal Endoscopic Foraminoplasty and Discectomy for the Treatment of a Thoracic Disc Herniation.

Wagner R, Telfeian AE, Iprenburg M, Krzok G, Gokaslan Z, Choi DB, Pucci FG, Oyelese A.World Neurosurg. 2016 Jun;90:194-198. doi: 10.1016/j.wneu.2016.02.086. Epub 2016 Feb 28.PMID: 26931541

Transforaminal endoscopic spine surgery has emerged internationally as a minimally invasive technique that can be performed in an awake patient in the outpatient setting. Advances in high-definition endoscopic camera technologies as well as the availab …

Multi-level spine endoscopy: A review of available evidence and case report.

Middleton SD, Wagner R, Gibson JNA.EFORT Open Rev. 2017 Jul 12;2(7):317-323. doi: 10.1302/2058-5241.2.160087. eCollection 2017 Jul.PMID: 28828180 Free PMC article.

In the last ten years, there has been an exponential increase in endoscopic spinal surgery practice.With improvements in equipment quality and the availability of high definition camera systems, cervical endoscopic disc resection is now a viable alternative t …

Letter to the editor concerning "transforaminal endoscopic surgery for lumbar stenosis: a systematic review" (Nellensteijn et al.).

Fürstenberg CH, Wagner R, Schubert M, Alfen FM, Krzok G, Gibson A.Eur Spine J. 2011 Jun;20(6):987-8; author reply 989-90. doi: 10.1007/s00586-010-1631-3. Epub 2010 Nov 26.PMID: 21110207 Free PMC article. No abstract available.

Interspinous endoscopic lumbar decompression: technical note.

Houle P, Telfeian AE, Wagner R, Bae J.AME Case Rep. 2019 Oct 16;3:40. doi: 10.21037/acr.2019.09.07. eCollection 2019.PMID: 31728438 Free PMC article.

Lumbar stenosis is a very common degenerative spine condition that can result in radicular and claudication symptoms. Here we describe our experience with a novel midline interspinous process endoscopic decompression procedure that can be performed in awake patients …

Endoscopic Surgical Technique for Treating Sacral Radiculopathy Secondary to S1 Nerve Compression After Minimally Invasive Sacroiliac Joint Fusion: Technical Note.

Wagner R, Telfeian AE, Krzok G, Iprenburg M.World Neurosurg. 2018 Nov;119:349-352. doi: 10.1016/j.wneu.2018.08.110. Epub 2018 Aug 24.PMID: 30149171

METHODS: Here we describe a minimally invasive endoscopic S1 nerve root decompression that does not require removing or revising the SI fusion implant. RESULTS: The postoperative course was uneventful, and the patient's radicular pain improved immediately after s …

Transforaminal Endoscopic Solution to a Kyphoplasty Complication: Technical Note.

Wagner R, Telfeian AE, Iprenburg M, Krzok G, Gokaslan Z, Choi DB, Pucci FG, Oyelese A.World Neurosurg. 2016 Jul;91:195-8. doi: 10.1016/j.wneu.2016.04.013. Epub 2016 Apr 9.PMID: 27072335

Kyphoplasty is a minimally invasive spine surgical procedure performed to stabilize and treat the pain caused by a spine compression fracture. ...A transforaminal endoscopic surgical approach was used to remove the cement and decompress the L2 n …

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

Hofstetter CP, Ahn Y, Choi G, Gibson JNA, Ruetten S, Zhou Y, Li ZZ, Siepe CJ, Wagner R, Lee JH, Sairyo K, Choi KC, Chen CM, Telfeian AE, Zhang X, Banhot A, Lokhande PV, Prada N, Shen J, Cortinas FC, Brooks NP, Van Daele P, Kotheeranurak V, Hasan S, Keorochana G, Assous M, Härtl R, Kim JS.Global Spine J. 2020 Apr;10(2 Suppl):111S-121S. doi: 10.1177/2192568219887364. Epub 2020 May 28.PMID: 32528794 Free PMC article.

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-ch …

Transforaminal Endoscopic Decompression for Displaced End Plate Fracture After Lateral Lumbar Interbody Fusion: Technical Note.

Wagner R, Telfeian AE, Krzok G, Iprenburg M.World Neurosurg. 2017 Oct;106:26-29. doi: 10.1016/j.wneu.2017.06.084. Epub 2017 Jun 20.PMID: 28645595

Here we present a case of end plate fracture and nerve compression after stand-alone lateral lumbar interbody fusion, its diagnosis, and its subsequent successful treatment with transforaminal endoscopic spine surgery. The case highlights the possible role fo …

Transforaminal endoscopic decompression of a postoperative dislocated bone fragment after a 2-level lumbar total disc replacement: case report.

Wagner R, Iprenburg M, Telfeian AE.Neurosurg Focus. 2016 Feb;40(2):E8. doi: 10.3171/2015.11.FOCUS15492.PMID: 26828889

The proposed advantages of total disc replacement (TDR) over fusion in the lumbar spine are the preservation of motion and the avoidance of adjacent-level disease. ...

Transpedicular endoscopic surgery for lumbar spinal synovial cyst-report of two cases.

Krzok G, Telfeian AE, Wagner R, Iprenburg M.J Spine Surg. 2016 Dec;2(4):310-313. doi: 10.21037/jss.2016.09.02.PMID: 28097248 Free PMC article.

Percutaneous access to the cysts was established by drilling through the adjacent pedicle creating a 7-mm corridor to establish access for the endoscopic tubular retractor and the working channel endoscope. ...RESULTS: Following surgery, the patients' symptom …

Comparative Study Between Uniportal Full-Endoscopic Interlaminar and Tubular Approach in the Treatment of Lumbar Spinal Stenosis: A Pilot Study.

Carrascosa-Granada A, Velazquez W, Wagner R, Saab Mazzei A, Vargas-Jimenez A, Jorquera M, Albacar JAB, Sallabanda K.Global Spine J. 2020 Apr;10(2 Suppl):70S-78S. doi: 10.1177/2192568219878419. Epub 2020 May 28.PMID: 32528810 Free PMC article.

OBJECTIVES: To compare tubular and endoscopic interlaminar approach. METHODS: Patients with lumbar spinal stenosis and neurogenic claudication of were randomized to tubular or endoscopic technique. ...Clinical follow up at 1, 3, 6 months after surgery with vi …

Minimally invasive fully endoscopic two-level posterior cervical foraminotomy: technical note.

Wagner R, Telfeian AE, Iprenburg M, Krzok G.J Spine Surg. 2017 Jun;3(2):238-242. doi: 10.21037/jss.2017.05.06.PMID: 28744507 Free PMC article.

Minimally invasive techniques and tubular retractor systems are available to minimize tissue retraction, but minimally invasive approaches can carry with them the surgical challenge of trying to pass instruments through a long narrow retractor that is also the port for vis …

Contralateral facet-sparing sublaminar endoscopic foraminotomy for the treatment of lumbar lateral recess stenosis: technical note.

Krzok G, Telfeian AE, Wagner R, Hofstetter CP, Iprenburg M.J Spine Surg. 2017 Jun;3(2):260-266. doi: 10.21037/jss.2017.06.11.PMID: 28744510 Free PMC article.

The standard surgical treatment for symptomatic lumbar lateral recess stenosis often requires a laminectomy or hemi-laminectomy and medial facetectomy which can further destabilize a pathological motion segment. The authors present here a novel technique for contralateral …

The Endoscopic Trans-Superior Articular Process Approach: A Novel Minimally Invasive Surgical Corridor to the Lateral Recess.

Hasan S, White-Dzuro B, Barber JK, Wagner R, Hofstetter CP.Oper Neurosurg (Hagerstown). 2020 Jul 1;19(1):E1-E10. doi: 10.1093/ons/opaa054.PMID: 32281629

BACKGROUND: Transforaminal approaches to the lumbar spine are typically performed utilizing Kambin's triangle as approach corridor; however, degenerative changes can distort anatomy and expose the exiting nerve root to inadvertent injury. OBJECTIVE: To describe the …





Symposium in Corona-Zeiten

Auch medizinische Kongresse und Fortbildungen werden zur Zeit häufig abgesagt. Deshalb nahm Dr. Wagner Ende April am ersten globalen Online Wirbelsäulen Endoskopie Symposium teil. In Videovorführungen demonstrierte er die Anwendungsmöglichkeiten endoskopischer Wirbelsäulenchirurgie. Anschließend führte er Live-Diskussionen mit internationalen Kollegen. weitere Informationen vom Veranstalter joimax, Karlsruhe