scholarly journals PERCUTANEOUS ENDOSCOPIC DISCECTOMY FOR DEGENERATIVE-DYSTROPHIC DISEASE OF THE LUMBAR SPINE

2006 ◽  
pp. 016-021
Author(s):  
Aleksandr Timofeyevich Khudyaev ◽  
Sergey Vladimirovich Lyulin ◽  
Elena Nikolayevna Schurova
Keyword(s):  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Degenerative Spondylolisthesis ◽  
Pain Syndrome ◽  
Invasive Technique ◽  
Intervertebral Disc Herniation ◽  
Endoscopic Discectomy ◽  
Radicular Syndrome

Objective. To determine a rational surgical strategy and approach to the treatment of patients with degenerativedystrophic disorders of the lumbar spine by percutaneous endoscopic discectomy. Material and Methods. Percutaneous endoscopic nucleotomy was applied in surgical treatment of 60 patients. Out of them 46 patients had L4–L5 intervertebral disc herniation, 7 patients had L3–L4 intervertebral disc herniation, 2 patients – L4–L5 hernia relapse after microdiscectomy, 1 patient – ossificated foraminal hernia at L3–L4, 3 patients – unstable degenerative spondylolisthesis at L4 level, and 1 – the same at L3. Complex examination of patients included acquisition of complaints and anamnestic data, general clinical, neurological, laboratory, and radiologic evaluation. All patients had CT images, in 10 cases they were added by MRI, and in 16 cases – by CT myelography. Pain syndrome intensity was assessed by digital rating and visual-analogue scales allowing the analysis of pain at rest, in motion, and at night. Results. Pain syndrome was arrested in 51 patients. Two patients showed residual radicular syndrome in the early postoperative period, and seven patients – residual reflex pain syndrome. Three months after the operation moderate reflex pain syndrome was observed in 6 cases, radicular syndrome in no one case. No aggravation of neurological deficit occured at the later follow-up period. Conclusion. Percutaneous endoscopic nucleotomy is a minimal invasive technique for lumbar disc hernia removal which reduces hospitalisation terms and risk of postoperative complications.

scholarly journals The Clinical Diagnostic Value of Lumbar Intervertebral Disc Herniation Based on MRI Images

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Kangxing Zheng ◽  
Zihuan Wen ◽  
Dehuai Li
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Facet Joint ◽  
Lumbar Disc ◽  
Herniated Disc ◽  
Intervertebral Disc Herniation ◽  
Facet Joints ◽  
Lumbar Intervertebral Disc ◽  
Lumbar Intervertebral Disc Herniation

MRI was used to measure the changes in the angle of the facet joints of the lumbar spine and analyze the relationship between it and the herniated lumbar intervertebral disc. Analysis of the causes of lumbar disc herniation from the anatomy and morphology of the spine provides a basis for the early diagnosis and prevention of lumbar disc herniation. There is a certain correlation between the changes shown in MRI imaging of lumbar disc herniation and the TCM syndromes of lumbar intervertebral disc herniation. There is a correlation between the syndromes of lumbar disc herniation and the direct signs of MRI: pathological type, herniated position, and degree of herniation. Indirect signs with MR, nerve root compression and dural sac compression, are related. The MRI examination results can help syndrome differentiation to improve its accuracy to a certain extent. MRI has high sensitivity for the measurement of the angle of the facet joints of the lumbar spine and can be used to study the correlation between the changes of the facet joint angles and the herniated disc. Facet joint asymmetry is closely related to lateral lumbar disc herniation, which may be one of its pathogenesis factors. The herniated intervertebral disc is mostly on the sagittal side of the facet joint, and the facet joint angle on the side of the herniated disc is more sagittal. The asymmetry of the facet joints is not related to the central lumbar disc herniation, and the angle of the facet joints on both sides of the central lumbar disc herniation is partial sagittal.

scholarly journals Evaluation of the effectiveness of surgical methods for the treatment of recurrent lumbar disc herniation: a cohort retrospective study

2021 ◽  
Vol 18 (2) ◽  
pp. 34-43
Author(s):  
M. N. Kravtsov ◽  
I. A. Kruglov ◽  
S. D. Mirzametov ◽  
A. S. Seleznev ◽  
N. P. Alekseyeva ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Interbody Fusion ◽  
Lumbar Disc ◽  
Disc Replacement ◽  
Single Level ◽  
Surgical Methods ◽  
Endoscopic Discectomy ◽  
Recurrent Lumbar Disc Herniation

Objective. To compare the effectiveness of surgical methods for treating patients with recurrent lumbar disc herniation.Material and Methods. The sample consisted of 160 patients operated on in 2014–2019 for recurrent lumbar disc herniation by percutaneous endoscopic discectomy (Group 1), microsurgical discectomy (Group 2), single-level transforaminal interbody fusion (Group 3) and single-level total intervertebral disc replacement (Group 4). The effectiveness of surgical treatment was evaluated using the NRS-11, ODI, and MacNab questionnaires.Results. Assessment of the pain syndrome severity and the vital activity level of patients revealed significant (p < 0.05) differences in favor of total intervertebral disc replacement. Excellent and good outcomes after arthroplasty according to MacNab criteria were noted in all patients in this group. Similar outcomes were reported in 77.5 % (31/40) of patients in the TLIF group, in 75.1 % (24/32) of patients in the percutaneous endoscopic discectomy group and in 72.6 % (45/62) of patients in the microdiscectomy group. The operation time and length of hospital stay were shorter in the endoscopic and microsurgical discectomy groups (p < 0.001). However, the lower incidence of complications and reoperations was observed in groups of posterior interbody fusion and arthroplasty (p > 0.05).Conclusion. Arthroplasty with the M6-L implant expands the possibilities of surgery for recurrent lumbar disc herniation. Total intervertebral disc replacement and posterior interbody fusion for recurrent lumbar disc herniation are more effective in comparison with decompressive operations, which is reflected in the improvement of clinical treatment outcomes, reduction of perioperative complications and frequency of repeated interventions.

scholarly journals Surgical Treatment for Extraforaminal Intervertebral Disc Herniation of the Lumbar Spine.

1996 ◽  
Vol 45 (3) ◽  
pp. 732-735 ◽  
Author(s):  
Masao Kifune ◽  
Daishiro Yuge ◽  
Hiroshi Mimura ◽  
Kazuhiro Sakai ◽  
Katsumi Nakamura ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Disc Herniation ◽  
Intervertebral Disc Herniation
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