Minimally Invasive Surgery of Lumbar Disc Herniation

Abstract Background: Calcified lumbar disc herniation (CLDH) is considered to be a special type of lumbar disc herniation (LDH). Percutaneous endoscopic interlaminar discectomy (PEID), with safety and efficacy, has been proved to be a minimally invasive surgery for LDH. However, there are few studies on PEID in the treatment of CLDH at L5-S1 level. This research aimed to analyze the clinical efficacy of PEID for L5-S1 CLDH.Methods: From August 2016 to April 2020, we retrospectively analyzed 28 consecutive patients (17 males; 11 females) with L5-S1 CLDH treated with PEID at our institution. All the patients were followed up for greater than 1 year postoperatively. The demographic characteristics, surgical results and clinical outcomes estimated by the visual analog scale (VAS) for leg pain, Oswestry disability index (ODI) and modified MacNab criteria were collected.Results: All patients were successfully performed by PEID. The mean operative time and intraoperative blood loss were 65.36 ± 5.26 minutes and 13.21 ± 4.35 ml, respectively. The VAS for leg pain and ODI scores improved remarkably from 7.54 ± 0.96 to 1.50 ± 0.51 (P < 0.05) and from 69.29 ± 9.91 to 17.43 ± 3.69 (P < 0.05) a year after operation, respectively. According to the modified MacNab criteria of the last follow-up, the excellent and good rates are 92.86%. Two of the patients had complications, one had nerve root injury and the other had postoperative dysesthesia.Conclusions: PEID achieved good clinical outcomes in the treatment of L5-S1 CLDH. And PEID was a safe and effective minimally invasive surgery for L5-S1 CLDH.

Download Full-text

Minimally Invasive Surgery with Spotlight Work Channel System in the Treatment of Lumbar Disc Herniation: A Retrospective Study of 21 Cases

Cell Biochemistry and Biophysics ◽

10.1007/s12013-014-0190-3 ◽

2014 ◽

Vol 71 (1) ◽

pp. 243-248 ◽

Cited By ~ 1

Author(s):

Haidong Xu ◽

Fengyu Jia ◽

Yanbin Liu ◽

Qiang Fu

Keyword(s):

Minimally Invasive Surgery ◽

Retrospective Study ◽

Minimally Invasive ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Invasive Surgery ◽

Lumbar Disc ◽

Channel System

Download Full-text

Minimally invasive decompression for lumbar stenosis and disc herniation

Neurosurgical FOCUS ◽

10.3171/foc/2008/25/8/e11 ◽

2008 ◽

Vol 25 (2) ◽

pp. E11 ◽

Cited By ~ 29

Author(s):

Sean S. Armin ◽

Langston T. Holly ◽

Larry T. Khoo

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Disc Herniation ◽

Invasive Surgery ◽

Lumbar Disc ◽

Invasive Technique ◽

Lumbar Stenosis ◽

New Techniques ◽

Pathological Conditions ◽

Minimally Invasive Decompression

For decades, lumbar disc herniation and lumbar stenosis have been treated surgically via traditional open techniques. With recent emphasis on minimally invasive approaches in spine surgery, a number of new techniques has been introduced that are aimed at treating these 2 common pathological conditions. Currently the most widely used and efficacious minimally invasive technique for treating these disorders is direct decompression with minimally invasive surgery. Due to the scarcity of large randomized studies, however, it is difficult to compare the effectiveness and possible superiority of this technique with traditional decompression. Further studies are needed to evaluate this issue.

Download Full-text

Quantitative Evaluation of the Trauma of CT Navigation PELD and OD in the Treatment of HLDH: A Randomized, Controlled Study

January 2018 - Pain Physician ◽

10.36076/ppj.2021.24.e433 ◽

2021 ◽

pp. E433-E441

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Computerized Tomography ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Randomized Study ◽

Tnf Alpha ◽

Serum Concentrations ◽

Post Operation

BACKGROUND: More evidence is required to support that computerized tomography navigation percutaneous spinal endoscopy in the treatment of highly migrated lumbar disc herniation is a more minimally invasive surgery than open discectomy . OBJECTIVE: To quantitatively evaluate the efficacy and minimal invasiveness of computerized tomography navigation percutaneous spinal endoscopy and open discectomy in highly migrated lumbar disc herniation. STUDY DESIGN: A prospective randomized study. SETTING: First Affiliated Hospital of Gannan Medical College. METHODS: From August 2016 to February 2020, 68 patients with highly migrated lumbar disc herniation had undergone discectomy. Thirty-five of them randomly received computerized tomography (CT) navigation percutaneous spinal endoscopy at the pain department (CT navigation percutaneous spinal endoscopy group), and 33 patients received open discectomy at the orthopedics department (open discectomy group). The Visual Analog Scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and modified MacNab criteria were applied to evaluate the clinical situations pre- and post-operation. The serum concentrations of IL-6, TNF-alpha, creatine phosphokina (CPK), and C-reactive protein (CRP) in the 2 groups were quantitatively measured. RESULTS: The postoperative VAS scores of the back and lower extremity were lower than those pre-operation in both groups, while the VAS score of back pain in the open discectomy group was significantly higher than that in the CT navigation percutaneous spinal endoscopy group at one week post-operation (P < 0.01). The postoperative JOA scores were significantly higher than those pre-operation in both groups. The serum concentrations of IL-6, TNF-alpha, CPK, and CRP in the open discectomy group were higher than those in the computerized tomography navigation percutaneous spinal endoscopy group postoperatively (P < 0.01). LIMITATIONS: This is a single-center randomized study and with the limitation of the sample size. CONCLUSION: CT navigation percutaneous spinal endoscopy is a more minimally invasive surgery than open discectomy. Certificate number for the medical institution conducting the clinical trials for humans in China: 934. KEY WORDS: Highly migrated lumbar disc herniation, endoscopic, CT navigation, trauma

Download Full-text