scholarly journals Comparison of microendoscopic discectomy and percutaneous transforaminal endoscopic discectomy for upper lumbar disc herniation

Medicine ◽  
2021 ◽  
Vol 100 (46) ◽  
pp. e27914
Author(s):  
WeiJun Xu ◽  
Bingxuan Yang ◽  
Xidan Lai ◽  
Xinxin Hong ◽  
Zihao Chen ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Microendoscopic Discectomy ◽  
Upper Lumbar Disc Herniation

scholarly journals Percutaneous transforaminal endoscopic discectomy compared with microendoscopic discectomy for lumbar disc herniation: 1-year results of an ongoing randomized controlled trial

2018 ◽  
Vol 28 (3) ◽  
pp. 300-310 ◽  
Author(s):  
Zihao Chen ◽  
Liangming Zhang ◽  
Jianwen Dong ◽  
Peigen Xie ◽  
Bin Liu ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Controlled Trial ◽  
Lumbar Disc ◽  
Treatment Groups ◽  
Randomized Controlled ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Microendoscopic Discectomy

OBJECTIVEA prospective randomized controlled study was conducted to clarify whether percutaneous transforaminal endoscopic discectomy (PTED) results in better clinical outcomes and less surgical trauma than microendoscopic discectomy (MED).METHODSIn this single-center, open-label, randomized controlled trial, patients were included if they had persistent signs and symptoms of radiculopathy with corresponding imaging-confirmed lumbar disc herniation. Patients were randomly allocated to the PTED or the MED group by computer-generated randomization codes. The primary outcome was the Oswestry Disability Index (ODI) score 1 year after surgery. Secondary outcomes included scores of the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain and physical function scales, EuroQol Group’s EQ-5D , and the visual analog scales for back pain and leg pain. Data including duration of operation, in-bed time, length of hospital stay, surgical cost and total hospital cost, complications, and reoperations were recorded.RESULTSA total of 153 participants were randomly assigned to 2 treatment groups (PTED vs MED), and 89.5% (137 patients) completed 1 year of follow-up. Primary and secondary outcomes did not differ significantly between the treatment groups at each prespecified follow-up point (p > 0.05). For PTED, there was less postoperative improvement in ODI score in the median herniation subgroup at 1 week (p = 0.027), 3 months (p = 0.013), 6 months (p = 0.027), and 1 year (p = 0.028) compared with the paramedian subgroup. For MED, there was significantly less improvement in ODI score at 3 months (p = 0.008), 6 months (p = 0.028), and 1 year (p = 0.028) in the far-lateral herniation subgroup compared with the paramedian subgroup. The total complication rate over the course of 1 year was 13.75% in the PTED group and 16.44% in the MED group (p = 0.642). Five patients (6.25%) in the PTED group and 3 patients (4.11%) in the MED group suffered from residue/recurrence of herniation, for which reoperation was required.CONCLUSIONSOver the 1-year follow-up period, PTED did not show superior clinical outcomes and did not seem to be a safer procedure for patients with lumbar disc herniation compared with MED. PTED had inferior results for median disc herniation, whereas MED did not seem to be the best treatment option for far-lateral disc herniation.Clinical trial registration no.: NCT01997086 (clinicaltrials.gov).

scholarly journals A comparative study on short-term therapeutic effects of percutaneous transforaminal endoscopic discectomy and microendoscopic discectomy on lumbar disc herniation

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Fei Wang ◽  
Dong Guo ◽  
Tiansheng Sun ◽  
Kai Guan
Keyword(s):  
Hospital Stay ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Therapeutic Effects ◽  
Short Term ◽  
Surgical Time ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Microendoscopic Discectomy

Objective: To find out the short-term effects of percutaneous transforaminal endoscopic discectomy (PTED) and microendoscopic discectomy (MED) on lumbar disc herniation (LDH). Methods: Ninety LDH patients treated in PLA Army General Hospital from July 2015 to July 2016 were selected and randomly divided into an MED group and a PTED group. Length of incision, amount of intraoperative bleeding, surgical time, number of times using intraoperative fluoroscopy, postoperative bedridden time, hospital stay, together with visual analogue scale (VAS) and Oswestry disability index (ODI) scores before surgery, three days, three months and six months after surgery were analyzed. Results: As regards the length of surgical incision, amount of bleeding, postoperative bedridden time and hospital stay, the PTED group was significantly superior to the MED group ((P=0.000, 0.000, 0.000, 0.001, respectively)). Compared with the PTED group, the MED group used less fluoroscopy and had shorter surgical time (P=0.001, 0.000, respectively). The postoperative VAS and ODI scores of both groups were significantly improved compared with those before surgery (P<0.000, 0.000, respectively). The short-term postoperative low back pain (LBP) VAS score of PTED group was lower than that of MED group (P=0.001). The two groups had similar leg pain (LP) VAS score three and six months after surgery, postoperative and follow-up LP VAS and ODI scores, and surgical improvement rate (P=0.093, 0.097, respectively). Conclusion: LDH was effectively treated by both PTED and MED. Compared with MED, PTED had less trauma, less blood loss, and faster recovery after surgery. How to cite this:Wang F, Guo D, Sun T, Guan K. A comparative study on short-term therapeutic effects of percutaneous transforaminal endoscopic discectomy and microendoscopic discectomy on lumbar disc herniation. Pak J Med Sci. 2019;35(2):---------.  doi: https://doi.org/10.12669/pjms.35.2.650 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Comparison of Percutaneous Transforaminal Endoscopic Discectomy and Microendoscopic Discectomy for the Surgical Management of Symptomatic Lumbar Disc Herniation: A Multicenter Retrospective Cohort Study with a Minimum of 2 Years’ Follow-Up

2020 ◽  
Vol 1;24 (1;1) ◽  
pp. E117-E125
Keyword(s):  
Minimally Invasive ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Retrospective Cohort ◽  
Lumbar Disc ◽  
Time Points ◽  
Intraoperative Fluoroscopy ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Microendoscopic Discectomy

BACKGROUND: Percutaneous transforaminal endoscopic discectomy (PTED) and microendoscopic discectomy (MED) are alternative minimally invasive procedures for the treatment of symptomatic lumbar disc herniation (LDH). However, insufficient literature exists to highlight the differences between the procedures. OBJECTIVES: This study intended to clarify whether PTED results in better clinical outcomes compared with MED in the surgical management of single-level LDH. STUDY DESIGN: A multicenter retrospective cohort study. SETTING: This study took place in 2 spinal minimally invasive centers in Beijing, China. METHODS: A multicenter retrospective study was conducted in consecutive patients diagnosed with symptomatic LDH receiving PTED or MED in 2 spinal minimally invasive centers from April 2009 to July 2016. A total of 1,053 patients were recruited, of which 632 underwent PTED and 421 underwent MED. All patients were followed with a minimum of 2 years; a set of clinical outcomes were extracted and analyzed. RESULTS: The operation time was similar between groups (71.2 ± 15.1 minutes in the PTED group and 69.4 ± 12.5 minutes in the MED group; P = 0.518); length of incision was significantly shorter; intraoperative blood loss was less in the PTED group (P < 0.001); hospital stay was 3.6 ± 1.5 days in the PTED group and 5.4 ± 2.8 days in the MED group with significant differences detected (P = 0.018); however, intraoperative fluoroscopy was longer with significantly higher cost with the PTED group (P < 0.001). Transient dysesthesia and wound complications were more common in the MED group (P = 0.039 and P = 0.026, respectively); however, no significant differences were found with total complications (P = 0.139). Significant lower Visual Analog Scale pain score (back and leg) were detected on day 1 postoperatively (P = 0.007 and P = 0.018, respectively). No significant differences were found at all other time points (P > 0.05). Significantly better Oswestry Disability Index (ODI) score was detected postoperatively at 1 month in the PTED group (19.6 ± 9.8 vs. 27.2 ± 9.3; P = 0.016); ODI score at other time points did not differ significantly between groups (P > 0.05). Modified MacNab criteria showed that most patients experienced excellent and good results with no significant differences between groups (P = 0.511). LIMITATION: This was a multicenter retrospective study wherein the surgeons may have introduced bias to the study. CONCLUSIONS: Both PTED and MED present to be an acceptable long-term efficacy for the treatment of LDH. Although PTED is associated with longer intraoperative fluoroscopy and a little more cost, it should still be considered superior to MED considering the benefits of lesser invasion, shorter hospital stays, quicker pain relief, and functional recovery. KEY WORDS: Percutaneous transforaminal endoscopic discectomy, microendoscopic discectomy, lumbar disc herniation, VAS score, ODI score

Comparison of Outcomes Postoperation between Straight Leg Raising Test Negative and Positive Patients Who Underwent Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation

2019 ◽  
Author(s):  
Feilong Wei ◽  
Haoran Gao ◽  
Yifang Yuan ◽  
Shu Qian ◽  
Quanyou Guo ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Related Factors ◽  
Significant Difference ◽  
Endoscopic Discectomy ◽  
Straight Leg Raising ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Relevant Factors

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.

scholarly journals Comparative Study between Full-Endoscopic Discectomy and Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 710
Author(s):  
Muneyoshi Fujita ◽  
Tomoaki Kitagawa ◽  
Masahiro Hirahata ◽  
Takahiro Inui ◽  
Hirotaka Kawano ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Disc Height ◽  
Leg Pain ◽  
Height Loss ◽  
Common Disease ◽  
Low Back ◽  
Endoscopic Discectomy ◽  
Microendoscopic Discectomy

Background and objectives: Lumbar disc herniation (LDH) is a common disease in the meridian of life. Although surgical discectomy is commonly used to treat LDH, there are several different strategies. We compared the outcomes of uniportal full-endoscopic discectomy (FED) with those of microendoscopic discectomy (MED) in treating LDH. Materials and Methods: FED was performed using a 4.1-mm working channel endoscope, and MED was performed using a 16-mm diameter tubular retractor and endoscope. Data of patients with LDH treated with FED (n = 39) or MED (n = 27) by the single surgeon were retrospectively reviewed. Patient background information and operative data were collected. Pre- and postoperative low back and leg pain were evaluated using the numerical rating scale (NRS) score. Pre- and postoperative disc height index (DHI) values were calculated from plain radiographs, and the disc height loss was evaluated using the ratio (DHI ratio); Results: The median (interquartile range (IQR) Q25–75) operation times for FED and MED were 42 (33–61) and 43 (33–50) minutes, respectively. The median (IQR Q25–75) pre- and postoperative NRS scores for low back pain were 5 (2–7) and 1 (0–4), respectively, for FED and 6 (3–8) and 1 (0–2), respectively, for MED. The median (IQR Q25–75) pre- and postoperative NRS scores for leg pain were 7 (5–8) and 0 (0–2), respectively, for FED and 6 (5–8) and 0 (0–2), respectively, for MED. These data were not different between the FED and MED groups. The median (IQR Q25–75) DHI ratios of FED and MED were 0.94 (0.89–1.03) and 0.90 (0.79–0.95), respectively. The DHI ratio was significantly higher (p < 0.05) in the FED group than in the MED group, and there was less blood loss; Conclusions: The pain-relieving effect of FED in treating LDH was almost identical to that of MED. However, FED was superior to MED in preventing disc height loss, which is one of the indicators of postoperative disc degeneration.

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