scholarly journals Feasibility and Efficacy of Percutaneous Lateral Lumbar Discectomy in the Treatment of Patients with Lumbar Disc Herniation: A Preliminary Experience

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Wenjin Jiang ◽  
Bolin Sun ◽  
Qirui Sheng ◽  
Xuepeng Song ◽  
Yanbo Zheng ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Japanese Orthopaedic Association ◽  
Japanese Orthopaedic Association Score ◽  
Lumbar Discectomy ◽  
Analog Scale ◽  
Association Score ◽  
Lumber Disc Herniation

Objective. This study was aimed at evaluating the effectiveness and safety of percutaneous lateral lumbar discectomy (PLLD) in treating patients with lumber disc herniation.Methods. A total of 183 patients with lumbar disc herniation were recruited to receive PLLD surgery from April 2006 to October 2011. All the adverse effects were recorded during the follow-up at 1, 3, 6, and 12 months after PLLD. The clinical outcomes were determined by visual analog scale and Japanese Orthopaedic Association score.Results. The surgery was performed successfully in all patients (102 males and 81 females aged from 21 to 66 years) with a mean 16.6-month follow-up (range from 26 to 65 months). No postoperative complications, including intestinal and vascular complications, nerve injuries, and postoperative infections, were associated with PLLD. At one month after surgery, visual analog scale (3.12±1.44versus6.76±2.31,P<0.05) was significantly lower than the baseline and was sustained until 24 months after surgery (3.25±1.78versus6.76±2.31,P<0.05). Besides that, Japanese Orthopaedic Association score (25.25±3.21versus11.78±2.38,P<0.05) was increased when compared to the baseline.Conclusions. PLLD was a promising, mini-invasive, and effective treatment for lumber disc herniation.

scholarly journals Full-Endoscopic Lumbar Discectomy for Two Contiguous Level Adolescent Lumbar Disc Herniation

2020 ◽  
Author(s):  
lu mao ◽  
Bin Zhu ◽  
Xiaotao Wu ◽  
Feng Wang ◽  
Cong Zhang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Visual Analog Scale ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Analog Scale ◽  
One Stage ◽  
Interlaminar Approach ◽  
Endoscopic Lumbar Discectomy

Abstract Background: Symptomatic lumbar disc herniation is rarely seen among adolescents. Adolescent lumbar disc herniation (ALDH) accounts for 0.5% to 6.8% of all those treated. Evidently, to our knowledge, no studies have emphasized the operative technique to treat two contiguous level adolescent lumbar disc herniation simultaneously. In this study, we aim to investigate the feasibility and advantages of one-stage full-endoscopic lumbar discectomy（FELD）for two contiguous level ALDH. This is the first paper, to my knowledge, dealing with two contiguous level ALDH simultaneously with one-stage full-endoscopic lumbar discectomy.Methods: Between January 2014 and December 2019, patients received FELD surgery for lumbar disc herniation (LDH) in 2 main minimally invasive spine center of China were selected for screening of this study. Data of 5877 cases were retrospectively analyzed (2780 cases and 3097 cases, respectively). The inclusion criteria were patient under 21-year old, two contiguous level symptomatic lumbar disc herniation received one-stage 2 level PELD surgery. Visual analog scale (VAS) scores and modified Macnab criteria were used to assess the preoperative and postoperative clinical results.Results: 11 patients were enrolled in this study (0.19%,11/5877), 8 patients were male and 3 were female. 9 patients with LDH in the same side underwent single-incision 2 level FELD surgery via transforaminal approach. 2 patients with LDH in different side underwent FELD surgery via combined transforaminal and interlaminar approach. There were no immediate perioperative complications. The visual analog scale (VAS) decreased significantly in both early and late follow-up evaluations and these score demonstrated significant improvement in late follow-up (P <0.01). For the modified MacNab criteria, the final outcome results were excellent in 9 patients (81.8%), good in 1 patients (0.9%), fair in1 patients (0.9%), and the overall success rate was 90.9%.Conclusion: One-stage full-endoscopic lumbar discectomy for 2 level symptomatic ALDH is an effective and less invasive method, which can be considered as an alternative good technique for selected adolescent patients.

scholarly journals Full-endoscopic lumbar discectomy for two contiguous level adolescent lumbar disc herniation

2020 ◽  
Author(s):  
lu mao ◽  
Bin Zhu ◽  
Tao xiao Wu ◽  
Feng Wang ◽  
Cong Zhang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Visual Analog Scale ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Analog Scale ◽  
One Stage ◽  
Interlaminar Approach ◽  
Endoscopic Lumbar Discectomy

Abstract Background Symptomatic lumbar disc herniation is rarely seen among adolescents. Adolescent lumbar disc herniation (ALDH) accounts for 0.5–6.8% of all those treated. Evidently, to our knowledge, no studies have emphasized the operative technique to treat two contiguous level adolescent lumbar disc herniation simultaneously. In this study, we aim to investigate the feasibility and advantages of one-stage full-endoscopic lumbar discectomy(FELD)for two contiguous level ALDH. This is the first paper, to my knowledge, dealing with two contiguous level ALDH simultaneously with one-stage full-endoscopic lumbar discectomy. Methods Between January 2014 and December 2019, patients received FELD surgery for lumbar disc herniation (LDH) in 2 main minimally invasive spine center of China were selected for screening of this study. Data of 5877 cases were retrospectively analyzed (2780 cases and 3097 cases, respectively). The inclusion criteria were patient under 21-year old, two contiguous level symptomatic lumbar disc herniation received one-stage 2 level PELD surgery. Visual analog scale (VAS) scores and modified Macnab criteria were used to assess the preoperative and postoperative clinical results. Results 11 patients were enrolled in this study (0.19%,11/5877), 8 patients were male and 3 were female. 9 patients with LDH in the same side underwent single-incision 2 level FELD surgery via transforaminal approach. 2 patients with LDH in different side underwent FELD surgery via combined transforaminal and interlaminar approach. There were no immediate perioperative complications. The visual analog scale (VAS) decreased significantly in both early and late follow-up evaluations and these score demonstrated significant improvement in late follow-up (P < 0.01). For the modified MacNab criteria, the final outcome results were excellent in 9 patients (81.8%), good in 1 patients (0.9%), fair in1 patients (0.9%), and the overall success rate was 90.9%. Conclusion One-stage full-endoscopic lumbar discectomy for 2 level symptomatic ALDH is an effective and less invasive method, which can be considered as an alternative good technique for selected adolescent patients.

scholarly journals A Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Microdiscectomy for Lumbar Disc Herniation in the Korean: A Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Manyoung Kim ◽  
Sol Lee ◽  
Hyeun-Sung Kim ◽  
Sangyoon Park ◽  
Sang-Yeup Shim ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Lumbar Microdiscectomy ◽  
Surgical Methods ◽  
Endoscopic Lumbar Discectomy

Background. Among the surgical methods for lumbar disc herniation, open lumbar microdiscectomy is considered the gold standard. Recently, percutaneous endoscopic lumbar discectomy is also commonly performed for lumbar disc herniation for its various strong points. Objectives. The present study aims to examine whether percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy show better results as surgical treatments for lumbar disc herniation in the Korean population. Methods. In the present meta-analysis, papers on Korean patients who underwent open lumbar microdiscectomy and percutaneous endoscopic lumbar discectomy were searched, both of which are surgical methods to treat lumbar disc herniation. The papers from 1973, when percutaneous endoscopic lumbar discectomy was first introduced, to March 2018 were searched at the databases of MEDLINE, EMBASE, PubMed, and Cochrane Library. Results. Seven papers with 1254 patients were selected. A comparison study revealed that percutaneous endoscopic lumbar discectomy had significantly better results than open lumbar microdiscectomy in the visual analogue pain scale at the final follow-up (leg: mean difference [MD]=-0.35; 95% confidence interval [CI]=-0.61, -0.09; p=0.009; back: MD=-0.79; 95% confidence interval [CI]=-1.42, -0.17; p=0.01), Oswestry Disability Index (MD=-2.12; 95% CI=-4.25, 0.01; p=0.05), operation time (MD=-23.06; 95% CI=-32.42, -13.70; p<0.00001), and hospital stay (MD=-4.64; 95% CI=-6.37, -2.90; p<0.00001). There were no statistical differences in the MacNab classification (odds ratio [OR]=1.02; 95% CI=0.71, 1.49; p=0.90), complication rate (OR=0.72; 95% CI=0.20, 2.62; p=0.62), recurrence rate (OR=0.83; 95% CI=0.50, 1.38; p=0.47), and reoperation rate (OR=1.45; 95% CI=0.89, 2.35; p=0.13). Limitations. All 7 papers used for the meta-analysis were non-RCTs. Some differences (type of surgery (primary or revisional), treatment options before the operation, follow-up period, etc.) existed depending on the selected paper, and the sample size was small as well. Conclusion. While percutaneous endoscopic lumbar discectomy showed better results than open lumbar microdiscectomy in some items, open lumbar microdiscectomy still showed good clinical results, and it is therefore reckoned that a randomized controlled trial with a large sample size would be required in the future to compare these two surgical methods.

Percutaneous Endoscopic Lumbar Discectomy for Treating Cauda Equina Syndrome Due To Lumbar Disc Herniation

2021 ◽  
Author(s):  
Hai-Chao He ◽  
Xiao-qiang LV ◽  
Yong-Jin Zhang
Keyword(s):  
Back Pain ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Endoscopic Lumbar Discectomy

Abstract Background In recent decades, endoscopic techniques to treat lumbar disc herniation (LDH) have gained popularity in clinical practice. However, there is little literature on the use of percutaneous endoscopic lumbar discectomy (PELD) to treat cauda equina syndrome (CES) due to LDH. This study aims to evaluate the feasibility and clinical efficacy of PELD for treating CES caused by disc herniation, and as well as to report some technical strategies. Methods Between October 2012 and April 2018, 15 patients with CES caused by LDH at the early and intermediate stages of Shi’s classification were selected as the subjects of study, and underwent PELD. All patients were followed up for at least two years. The patients’ back pain and leg pain were 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 and at 3 days, 3 months, 6 months and the last follow-up. Results The VAS score for back pain, leg pain and ODI score significantly decreased from preoperatively scores of 6.67 ± 1.05, 7.13 ± 1.19 and 62.0 ± 6.85 respectively, to postoperatively cores of 1.80 ± 0.41, 1.47 ± 0.52 and 12.93 ± 1.03 at the last follow-up postoperatively. These postoperative scores were all significantly different compared with preoperative scores (P < 0.01). According to the modified MacNab outcome scale, 86.67% of these patients had excellent and good outcomes at the final follow-up. Complications included one patient with cerebrospinal fluid leakage and one patient who developed recurrent herniation; the latter patient finally achieved satisfactory results after reoperation. Conclusion PELD could be used as an alternative surgical method for the treatment of CES due to LDH in properly selected cases and appropriate patient selection. However, the operator should pay attention to foraminoplasty to enlarge the working space.

scholarly journals Long-Term Follow-Up Results of Day Surgery for Lumbar Disc Herniation Using Percutaneous Endoscopic Lumbar Discectomy: A Single-Center Experience of 267 Cases.

2020 ◽  
Author(s):  
Zhaojun Song ◽  
Maobo Ran ◽  
Juan Luo ◽  
Kai Zhang ◽  
Yongjie Ye ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Day Surgery ◽  
Lumbar Discectomy ◽  
Hospitalized Patients ◽  
Disc Height ◽  
Endoscopic Lumbar Discectomy

Abstract Background: Although numerous studies have shown good clinical results of percutaneous endoscopic lumbar discectomy (PELD) for hospitalized patients with lumbar disc herniation (LDH), there are few articles that report on the day surgery patients undergoing PELD.Methods: Atotal of 267 patients with LDH received PELD during day surgery were followed up for at least 3 years. Relevant data and clinical outcomeswere recorded and assessed. Meanwhile, we compared the clinical effects between patients treated by PELD during day surgery and microendoscopic discectomy (MED) for contemporaneous hospitalized patients with LDH (116 patients).Results: Patients treated by PELD had lower blood loss (10.8 ± 4.1 mL, 71.3 ± 23.3 mL,respectively; P < 0.001) and shorter hospital stay ( 22.7 ± 4.2 hours, 48.1 ± 22.6 hours, respectively; P < 0.001 ) compared with patients treated by MED. The visual analogue scale (VAS) for leg and back pain (VAS-L and VAS-B, respectively) and Oswestry disability index (ODI) decreased significantly after PELD than those before the operation at 3 years postoperative, and the postoperative VAS-B in PELD group was significantly decreased from the MED group ( P = 0.001). The complications rate was 9.4% (25/267) in the PELD group and 12.1% (14/116) in the MED group, without significant difference ( P = 0.471). The 1-year postoperative recurrence rate in PELD group ( 5.2%, 14/267) was much higher than that in MED group ( 0.9%, 1/116) ( P = 0.042). The postoperative lumbar lordosis（LL）(34.0 ±10.3 ), and sacral slope（SS) (27.5 ± 5.6) in PELD group improved significantly compared with the values in MED group (26.9 ± 9.8, 23.6 ± 6.8, respectively; all P < 0.001). The disc-height ratio at 3-year follow-up was ( 85.7 ± 6.4) % of the preoperative disc height in PELD group while ( 81.9 ± 7.0) % in MED group，with significant height loss in MED group ( P = 0.014).Conclusions: Day surgery for LDH undergoing PELD has favorable long-term outcomes.

Comparation of Percutaneous Endoscopic Lumbar Discectomy between Transforaminal Approach and Interlaminar Approach on Lumbar Disc Herniation of L4-L5: An Observational Study

2020 ◽  
Vol 103 (12) ◽  
pp. 1277-1283
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Demographic Data ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Interlaminar Approach ◽  
Endoscopic Lumbar Discectomy ◽  
Approach Group

Objective: To evaluate the clinical outcomes and complications of post percutaneous endoscopic lumbar discectomy (PELD) via transforaminal (TF) approach and interlaminar (IL) approach in patients with lumbar disc herniation L4-L5 level. Materials and Methods: Eighty-five patients diagnosed with lumbar disc herniation on L4-L5 level and who underwent PELD were non-randomly recruited and assigned into two groups. Fifty-two patients underwent PELD via the IL approach and thirty-three patients underwent PELD via the TF approach. The demographic data, resting visual analog scale (VAS), activity VAS, Oswestry Disability Index (ODI), and complications were obtained before the operation, and at follow-up on day 1, and at 2-, 6-, 12-, and 24-months post operation. Results: Resting VAS and activity VAS statistically significantly declined in both groups (p=0.001). Activities of daily living (ADL) as assessed by ODI increased significantly in both groups (p=0.001). However, there was no significant differences between the groups. The TF approach group had significant more dysesthesia and re-surgery (p=0.009, p=0.05, respectively) than the IL approach group. The total re-surgery rate during the two years of follow-up was in the 9.4%. Conclusion: PELD is a safe and effective minimal invasive spine surgery. The clinical results via both approaches have similar result but PELD via the TF approach had higher post-operative complications than via the IL approach. Additionally, PELD via the TF approach required higher skill to puncture and there is a steeper learning curve than PELD via the IL approach. Keywords: Percutaneous endoscopic lumbar discectomy, PELD, Transforaminal, Interlaminar

scholarly journals Percutaneous Endoscopic Lumbar Discectomy as an Alternative to Open Lumbar Microdiscectomy for Large Lumbar Disc Herniation

2016 ◽  
Vol 19 (2;2) ◽  
pp. E291-E300 ◽  
Author(s):  
Jin-Sung Kim
Keyword(s):  
Back Pain ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Disc Height ◽  
Herniated Disc ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Endoscopic Lumbar Discectomy

Background: Remarkable advancements in endoscopic spinal surgery have led to successful outcomes comparable to those of conventional open surgery. Large lumbar disc herniation (LLDH) is a serious condition, resulting in higher surgical failure when accessing the herniated disc. Objectives: This study compared the outcomes of LLDH treated with percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM). Study Design: Retrospective assessment. Methods: This retrospective observational study was conducted from January 2011 to June 2012. Forty-four consecutive patients diagnosed with LLDH without cauda equina syndrome who were scheduled to undergo spinal surgery were included. LLDH was defined as herniated disc fragment occupying > 50% of the spinal canal. Clinical outcomes were evaluated using a visual analogue scale (VAS, 0 – 10), functional status was assessed using the Oswestry Disability Index (ODI, 0 – 100%) at 1, 6, and 24 months postoperatively and surgical satisfaction rate (0 – 100%) at final follow up. Radiological variables were assessed by plain radiography. Results: Forty-three patients were included; 20 and 23 patients underwent PELD and OLM, respectively. Both groups exhibited significant improvements in leg and back pain postoperatively (P < 0.001). Although there was no significant difference in leg pain improvement between the groups, improvement in back pain was significantly higher in the PELD group than in the OLM group (4.9 ± 1.5 vs. 2.5 ± 1.0, P < 0.001). The surgical satisfaction rate of the PELD group was significantly higher than that of the OLM group (91.3% ± 6.5 vs. 84.3% ± 5.2, P < 0.001). Mean operating time, hospital stay, and time until return to work were significantly shorter in the PELD group than in the OLM group (67.8 vs. 136.7 minutes, 1.5 vs. 7.2 days, and 4.2 vs. 8.6 weeks; P < 0.001). Disc height (%) decreased significantly from 23.7 ± 3.3 to 19.1 ± 3.7 after OLM (P < 0.001), but did not change significantly after PELD (23.6 ± 3.2 to 23.4 ± 4.2; P = 0.703). The segmental angle of the operated level increased from 10.3° to 15.4° in the PELD group, which was significantly higher than that in the OLM group (9.6° to 11.6°; P = 0.038). In the OLM group, there was one case of fusion due to instability. In the PELD group, one case required revision surgery and another case experienced recurrence. There were no perioperative complications in either group. Limitation: The study was retrospective with a small sample size and short follow-up period. Conclusion: PELD can be an effective treatment for LLDH, and it is associated with potential advantages, including a rapid recovery, improvements in back pain, and disc height preservation. Key words: Large lumbar disc herniation, percutaneous endoscopic lumbar discectomy, microdiscectomy, back pain, disc height

scholarly journals Combination of Intraspine Interlaminar Device With Lumbar Discectomy in Patients With L5/S1 Disc Herniation

2020 ◽  
Author(s):  
Shitong Feng ◽  
Zihan Fan ◽  
Xiang Li ◽  
Jisheng Lin ◽  
Yong Yang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Clinical Symptoms ◽  
Lumbar Disc ◽  
Invasive Procedure ◽  
Lumbar Discectomy ◽  
Disc Height ◽  
Post Operation ◽  
Left And Right

Abstract Background. It is commonly recognized that interspinous spacers were not generally suitable for the application in L5-S1 level due to the short S1 spinous process.In this retrospective study, the feasibility and validity of the IntraSpine interlaminar device in the treatment of lumbar disc herniation on the L5/S1 level were evaluated.Methods. During the January 2018 and December 2018, a total of 30 patients, who were hospitalized in our hospital due to lumbar disc herniation (LDH) on the L5/S1 level, were included in the current study. The clinical symptoms before surgery, post-operation (3 days after surgery), 6 months after surgery, 12 months after surgery, and final follow-up were assessed using the back and leg visual analog scale (VAS), Oswestry disability index (ODI). Sagittal diameter of the lumbar spinal canal (SD), posterior disc height (PDH), left and right foramina height (LFH and RFH), left and right foramina width (LFW and RFW) were measured by sagittal reconstructions of CT scans. The range of motion (ROM) of L5-S1 level was estimated by lumbar dynamic X-ray images.Results. The back VAS, leg VAS, ODI, were significantly improved after surgery(P<0.05). The SD, PHD, LFH, RFH, LFW, and RFW after the operation and in the follow-up period were statistically different from those before surgery (P<0.05). The ROM of L5/S1 level at final follow-up was not statistically different from that before surgery (P = 0.299). 93.3% of patients demonstrated successful outcomes.Conclusions. The combination of IntraSpine interlaminar device with lumbar discectomy is an effective minimally invasive procedure for the treatment of L5/S1 disc herniation, which can delay and prevent the reduction of the disc height after discectomy in L5/S1 segment.

scholarly journals Comparison of Transforaminal Percutaneous Endoscopic Lumbar Discectomy with and without Foraminoplasty for Lumbar Disc Herniation: A 2-Year Follow-Up

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Binbin Wu ◽  
Gonghao Zhan ◽  
Xinyi Tian ◽  
Linyu Fan ◽  
Chenchen Jiang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operation Time ◽  
Lumbar Discectomy ◽  
Low Back ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Significant Difference ◽  
Endoscopic Lumbar Discectomy

Background. Both transforaminal percutaneous endoscopic lumbar discectomy with foraminoplasty (TF PELF) and transforaminal percutaneous endoscopic lumbar discectomy without foraminoplasty (TF PELD) were developed for lumbar disc herniation (LDH) patients. However, the safety and effectiveness between the TF PELF and TF PELD have not been investigated. Methods. Of the included 140 LDH patients, 62 patients received TF PELF (PELF group) and 78 patients received TF PELD (PELD group). The operation time, the duration of staying at the hospital, and complication incidences were recorded. All patients were followed up for 2 years, where low back and leg visual analogue scale (VAS) pain ratings and Oswestry Disability Index (ODI) were compared between the 2 groups before and after surgery. Modified Macnab criterion was estimated for all patients at postoperative 2 years. Results. There were no significant difference of the operation time, number of days staying at the hospital, and the incidence of complications between the 2 groups (P>0.05). Two cases in the PELF group and 1 case in the PELD group received a second surgery due to unrelieved symptoms postoperatively. Low back and leg VAS and ODI scores decreased in both groups after operation (P<0.01), respectively, but were not significant between the 2 groups over time (P>0.05). Six patients in the PELF group and 3 patients in the PELD group did not continue the follow-up; thus, only 131 patients completed Macnab evaluation. The satisfactory rate was reported as 80.4% in the PELF group and 90.7% in the PELD group (P>0.05). Conclusions. This study suggested that the safety and effectiveness of TF PELF are comparable to TF PELD for LDH patients.

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