scholarly journals Comparison of the clinical efficacy of percutaneous transforaminal endoscopic discectomy and traditional laminectomy in the treatment of recurrent lumbar disc herniation

Medicine ◽  
2021 ◽  
Vol 100 (30) ◽  
pp. e25806
Author(s):  
Shifeng Jiang ◽  
Qingning Li ◽  
Hongzhi Wang
2019 ◽  
Author(s):  
Feilong Wei ◽  
Haoran Gao ◽  
Yifang Yuan ◽  
Shu Qian ◽  
Quanyou Guo ◽  
...  

Abstract Background: Percutaneous Transforaminal Endoscopic Discectomy is used increasingly in patients with Lumbar Disc Herniation. There is little knowledge on the related factors including SLR test influencing the operation. Therefore, we designed this prospective study to explore the relevant factors influencing postoperative effect of PTED surgery.Methods: Consecutive patients with LDH who came to our hospital from August 2015 to September 2016 and received PTED surgery. 4 kinds of scales including VAS (lumbar/leg), ODI and JOA were measured and reassessed at 1 day, 3 months, 6 months, 12months and 36 months after the PTED to assess their surgical outcomes. Results: All the patients had successful surgery. ODI and VAS (lumbar/leg) decreased in all patients and groups. And there was a statistically significant difference in each postoperative follow-up compared with that before surgery in every visit. In addition, the increase of JOA in postoperation was statistically significant compared with that before surgery. And, there is statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°-) in the changes of the scores of VAS(leg), ODI and JOA. However, there is no statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°--RRB- in the changes of the score of VAS(lumbar). Conclusions: PTED showed great effect on treating patients with lumbar disc herniation. And the main scale score such as VAS(leg). ODI and JOA showed that there is a statistically significant difference between the three subpopulations treated by PTED. Patients with SLR negative may get greater benefit from PTED.


2020 ◽  
Author(s):  
Hai-Chao He ◽  
Yong-jin Zhang

Abstract Background: In the last decades, endoscopic techniques to treat lumbar disc herniation (LDH) have gained popularity in clinical practice. However, few studies have described the safety and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in treating adolescent massive LDH. This study aims to evaluate the surgical outcomes of PTED in treating adolescent patients with massive LDH. Methods: Between October 2012 and December 2018, retrospective analysis of 13 adolescent patients with single segment massive LDH at the Department of Spinal Surgery of Affiliated Dongyang Hospital of Wenzhou Medical University. All patients were followed up for at least 12 months (range 12–20 months). The patients’ lower limb pain was evaluated using visual analogue scale (VAS) scores and the Oswestry Disability Index (ODI). Patient satisfaction was evaluated using the MacNab outcome scale. Clinical outcomes were measured preoperatively, at 3 days, 1 months, 3 months, 6 month and 12 months postoperatively. Results: The VAS score for leg pain was 7.08 ±1.12 preoperatively and 3.23±1.01, 3.0 ± 1.01, and 2.62 ± 0.51, and 2.32± 0.48, and 1.46± 0.52, at 3 days, 1 months, 3 months, 6 months and 12 months postoperatively respectively. The ODI scores was 51.51 ±3.08 preoperatively and 21.74±1.15, 14.81 ± 1.50, and 2.78 ± 0.64, at 3 months, 6 months and 12 months postoperatively respectively. These postoperative scores were all significantly different when compared with preoperative scores (P < 0.001). According to the modified MacNab outcome scale, excellent was obtained in 7 patients, good was obtained in 5 patients, and fair was obtained in 1 patient, and 92.31% of these patients had excellent and good outcomes at the final follow-up. There were no complications related to surgery, and no spinal instability was detected. Conclusion: The PTED is an effective and safe surgical method for the treatment of adolescent patients with massive LDH, but high-quality randomized controlled trials are still required to further verify these findings.


2020 ◽  
Author(s):  
Quanyi Li ◽  
yongchun zhou

Abstract Purpose: To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) versus percutaneous transforaminal endoscopic discectomy (PTED) for treating lumbar disc herniation (LDH). Methods: The clinical data of 1,100 patients who had been diagnosed with LDH from January 2012 to December 2017 were retrospectively analysed. IFD was performed on the 605 patients in Group A, while PTED was performed on the 505 patients in Group B. The Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for pain, and modified Macnab criteria were adopted to evaluate the outcomes. Moreover, the surgery durations, intraoperative blood loss, postoperative off-bed activities, and postoperative lengths of hospital stay for the two groups were observed. Results: The follow-up period ranged from 24 months to 60 months, with an average duration of 43 months. As the excellent and good outcome rate was 93.5% in Group A and 92.6% in Group B, there were no significant differences in efficacy between the two groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest durations and postoperative lengths of hospital stay than did Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions: Although conventional IFD and PTED had similar levels of efficacy in treating LDH, transforaminal endoscopic discectomy exhibited several advantages, such as less trauma, less bleeding, and a shorter length of hospital stay, and it can be considered an ideal surgical option for treating LDH.Save and Continue


2021 ◽  
Author(s):  
Jun-Yan An ◽  
Jun Zhang ◽  
Jiu-Ping Wu ◽  
Tong Yu ◽  
Wu Xue ◽  
...  

Abstract Background . Lumbar disc herniation (LDH) is a common disease in spinal surgery which often causes acute radicular pain. However, LDH with buttock pain (BP) as the main clinical symptom is rare. Herein, we retrospectively evaluated the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of LDH with the buttock as the primary clinical symptom. Methods . Totally 12 patients have LDH (L4-5) with BP who underwent PTED from January 2019 to June 2020 were enrolled. All patients performed magnetic resonance imaging (MRI) and computed tomography (CT) preoperatively, 1 week postoperatively, and at follow-up. The pain relieve were evaluated by the Visual analog scale (VAS), the functional recovery was assessed by Oswestry disability index (ODI) and Roland-Morris questionnaire (RMQ). Parameters were evaluated preoperatively, immediately after surgery, 1 month, 3 months and 6 months after surgery, respectively. Moreover, the lumbar function was determined by modified MacNab criteria. Results . Pain relieve was found in 11 patients postoperatively. The VAS, ODI and RMQ scores were improved significantly at the latest follow up visit compared to preoperative (P < 0.05). One patient suffered from LDH recurrence one month after operation and received revision surgery, then achieved satisfied effect. Two patients experienced residual BP after operation and obtained good clinical outcomes by conservative treatment. No other surgical complications were found during follow up period. The average length of follow-up was 6.68 ± 0.67 months. Conclusion. PTED is a safe and efficacious method in treating LDH with BP.


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