1、07.07.20221joimax GmbH / Inc.RaumFabrik 33aAmalienbadstrasse76227 Karlsruhe GermanyFON +49 (0) 721 25514-0FAX +49 (0) 721 25514-020Mail Url THESSYSTransforaminal Endoscopic Spine System- Transforaminal Endoscopy- Total Fragmentectomy- Proving Disc Recovery07.07.20222THESSYS Discography Foraminoplast

2、y Fragmentectomy pression Nucleotomy Annuloplasty07.07.20223Different spinal surgical techniquesTreatment techniquesminimally invasiveCT controlled proceduresCatheter treatmentChemonucleolysisIDET, NucleoplastyEndoscopic TransforaminalFragmentectomyFacet-joint treatmentB-Twinmicro surgicalLaminectom

3、y/Hemilaminectomy pressionX-StopKyphoplasty - Vertebroplastyopen surgicalSpondylodesis/CagesDisc prosthesisSurgery of scoliosisRemoval of tumors07.07.20224Endoscopic Transforminal Fragmentectomy07.07.20225Indications and ContraindicationsCONTRAPure dorsal disc herniations PROParalysesDrop footDysfun

4、ction of the rectum or the bladderSevere long term painNo improvement with conservative treatment07.07.20226The THESSYS Endoscopic System07.07.2022707.07.20228Patient with L5-S1: MRI/CT/X-Ray07.07.20229Patient positioning: lateral or prone07.07.202210 THESSYS07.07.202211Marking, anesthesia and needl

5、e placement PDA with 13 ml Ropivacain 0,2%+10 g Sufentanil07.07.202212 THESSYS07.07.202213 THESSYS07.07.202214 THESSYS07.07.202215Discography with pressure control07.07.202216Placement of guiding rodes, tubes, reamersOver-the-wire principle07.07.202217 THESSYS07.07.202218 THESSYS07.07.202219 THESSYS

6、07.07.202220 THESSYS07.07.202221Ongoing A-P and lateral X-ray controls 07.07.202222Insertion of foraminoscope and orientationlateral facet-capsuleherniated fragment07.07.20222307.07.202224Endoscopic hernia removal with forcepses07.07.202225SurgiMax High Radiofrequency Probe07.07.202226 pressed sciat

7、ic nerv07.07.202227Sequester of the disc herniation07.07.20222807.07.202229 THESSYSMale, 66 Y Back pain and radicular pain left legHypesthesia in L5-DermatomSymptoms since 3 monthsNo relief after conservative therapy07.07.202230 THESSYS07.07.202231 THESSYSFemale, 45 YRadicular pain left legMissensat

8、ions in S1-dermatom Symptoms since 6 monthsComplete conservative therapy with mild relief07.07.202232 THESSYS07.07.202233Basic animation07.07.202234Postoperative SituationHealing Phasepost-OP day 1 - 14 Stabilisation Phase3.- 5. week post-OPNormalisation Phasefrom 6. post-OP week on07.07.202235Patie

9、nt satisfaction 6 months post-OPData are from studies in progress by: Dr. Alfen, Dr. Krzok, Dr. Isprenburg07.07.202236Patient satisfaction 1 year post-OP07.07.202237Pros and Cons of the methodPROSOnly locally anaesthetizedReduced wound healing pain Less subsequent scar formationDirect access to the

10、sequesterShort rehabilitation timeReduced risk of instability Reduced risk of infectionsCONSExperience required with percutaneous approaches3-dimensional imagination required with 2-dimensional controlsStereotactical work and manoeuveringTechnically demanding Patiency for learning curveEquipment req

11、uirements 07.07.2022383 months after operationPicking up cars and heavy logs for a living can be a bit demanding. A painful injury to his lower spine forced Strongman and actor Dieter Seidenkranz to take a break and- despite his enormous size and authorative muscles - restrain from his favourite hobby for a while. Dr. Hoogland operated the muscle-man endoscopically in September 2004. As the image shows, Dr. Hoogland and Dieter Seidenk