scholarly journals Transforaminal percutaneous endoscopic lumbar discectomy versus microdiscectomy: an Indian rural experience

2017 ◽  
Vol 3 (6) ◽  
pp. 1141
Author(s):  
Prakash U. Chavan ◽  
Mahendra Gudhe ◽  
Ashok Munde ◽  
Balaji Jadhav
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operating Time ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Single Level ◽  
Group I ◽  
Endoscopic Lumbar Discectomy

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare surgical outcome of micro-discectomy with transforaminal percutaneous endoscopic lumbar discectomy for single level lumbar disc herniation in Indian rural population.</p><p class="abstract"><strong>Methods:</strong> Retrospective comparative study was designed during the period of October 2012 to June 2015, patients in the age group of 22-75 years with unremitting sciatica with/without back pain, and/or a neurological deficit that correlated with appropriate level and side of neural compression as revealed on MRI, with single level lumbar disc herniation who underwent either microdiscectomy or TPELD were included in the study. Patients were assessed on visual analogue scale (VAS) for back and leg pain, modified macnabs criteria, the Oswestry Disability Index (ODI).<strong></strong></p><p class="abstract"><strong>Results:</strong> Group I (MD) included 44 patients and Group II (TPELD) included 20 patients. Significant improvement was seen in claudication symptom post-operatively in both MD and TPELD. Mean operating time was significantly shorter in MD group (1.11 hrs vs. 1.32 hrs; p&lt;0.01). According to modified MacNab's criteria,<strong> </strong>outcome were excellent (81.8%), good (9.09%) and fair<strong> </strong>(9.09%) in MD. Similarly, in TPELD, 80%, 15% and 5% patients had excellent, good and fair outcome respectively. In both groups, no one had a poor outcome. Thus, overall success rate was 100% in the study.</p><strong>Conclusions:</strong> TPELD and MD have comparable post-operative outcome in most of the efficacy parameters in Indian rural patients undergoing treatment of single level lumbar disc herniation. Additionally, TPELD offers distinct advantages such as performed under local anaesthesia, preservation of structure, lesser post-operative pain and early mobilization and discharge from hospital.

scholarly journals Retrospective Analysis of Paraspinal Muscle-Splitting Microscopic-Assisted Discectomy Versus Percutaneous Endoscopic Lumbar Discectomy on Patients in the Treatment of Far-Lateral Lumbar Disc Herniation

2020 ◽  
Author(s):  
Lei Kong ◽  
Wei-Zhi Zhang ◽  
Hong-Guang Xu
Keyword(s):  
Radiation Exposure ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operating Time ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Duration Of Hospitalization ◽  
Far Lateral ◽  
Endoscopic Lumbar Discectomy

Abstract Background: Minimally invasive surgery includes percutaneous endoscopic lumbar discectomy and the microscopic tubular technique. This study aimed to compare the two techniques and evaluate the outcomes of the procedures.Methods: We retrospectively analyzed patients with far-lateral lumbar disc herniation (FLLDH) from June 2015 to October 2018. Twenty-six patients underwent paraspinal muscle-splitting microscopic-assisted discectomy (MD) and 30 patients underwent percutaneous endoscopic lumbar discectomy (PELD) surgery by the same surgical team. Data included the duration of the operation, duration of intraoperative radiation exposure, and average duration of hospitalization. Pre- and postoperative pain scores and neurological functions were recorded using a visual analog scale (VAS) score and Oswestry disability index (ODI).Results: 56 patients remained in the study over the 12–24 months period. The mean operating time was 65.83 ± 16.64 min in the PELD group, mean duration of radiation exposure was 2.87 ± 1.19 min, and average of hospitalization was 3.43 days. The mean operating time was 44.96 ± 16.87 min in the MD group, duration of radiation exposure was 0.78 ± 0.32 min, and duration of hospitalization was 4.12 days. There were two patients with postoperative transient dysesthesia and one underwent reoperation 7 months after surgery in the PELD group. One patient had postoperative transient dysesthesia in the MD group. Except low back pain at 3 months (p >0.05), all patients in both groups showed significant improvement in VAS and ODI scores compared with pre-operation and until final follow-up (p<0.05). Although the learning curve of MD is shorter compared with the PELD, beginners should practice on cadavers and receive teaching demonstrations from senior surgeons.Conclusion: Both techniques are minimally invasive, effective, and safe for treating far-lateral lumbar disc herniation in selected patients. Compared with the PELD technique, the MD procedure offers a wider field of vision during operation, shorter operation time, fewer postoperative complications, and shorter learning curve.

scholarly journals A retrospective analysis of paraspinal muscle-splitting microscopic-assisted discectomy versus percutaneous endoscopic lumbar discectomy on patients in the treatment of far-lateral lumbar disc herniation

2020 ◽  
Author(s):  
LEI KONG ◽  
Hong Guang Xu
Keyword(s):  
Radiation Exposure ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operating Time ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Duration Of Hospitalization ◽  
Far Lateral ◽  
Endoscopic Lumbar Discectomy

Abstract Background : Minimally invasive surgery includes percutaneous endoscopic lumbar discectomy and the microscopic tubular technique. This study aimed to compare the two techniques and evaluate the outcomes of the procedures. Methods : We retrospectively analyzed patients with far-lateral lumbar disc herniation (FLLDH) from June 2015 to October 2018. Twenty-six patients underwent paraspinal muscle-splitting microscopic-assisted discectomy (MD) and 30 patients underwent percutaneous endoscopic lumbar discectomy (PELD) surgery by the same surgical team. Data included the duration of the operation, duration of intraoperative radiation exposure, and average duration of hospitalization. Pre- and postoperative pain scores and neurological functions were recorded using a visual analog scale (VAS) score and Oswestry disability index (ODI). Results: 56 patients remained in the study over the 12–24 months period. The mean operating time was 65.83 ± 16.64 min in the PELD group, mean duration of radiation exposure was 2.87 ± 1.19 min, and average of hospitalization was 3.43 days. The mean operating time was 44.96 ± 16.87 min in the MD group, duration of radiation exposure was 0.78 ± 0.32 min, and duration of hospitalization was 4.12 days. Except low back pain at 3 months (p >0.05), all patients in both groups showed significant improvement in VAS and ODI scores compared with pre-operation and until final follow-up (p<0.05). Conclusion: Both techniques are minimally invasive, effective, and safe for treating far-lateral lumbar disc herniation in selected patients. Compared with the PELD technique, the MD procedure offers a wider field of vision during operation, shorter operation time, fewer postoperative complications, and shorter learning curve.

scholarly journals The effect of paraspinal muscle-splitting microscopic-assisted discectomy versus percutaneous endoscopic lumbar discectomy on patients in the treatment of far-lateral lumbar disc herniation

2020 ◽  
Author(s):  
LEI KONG ◽  
Hong Guang Xu
Keyword(s):  
Radiation Exposure ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operating Time ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Far Lateral ◽  
The Mean ◽  
Endoscopic Lumbar Discectomy

Abstract Background Minimally invasive surgery includes percutaneous endoscopic lumbar discectomy and the microscopic tubular technique. This study aimed to compare the two techniques and evaluate the outcome of the procedure. Methods We retrospectively analyzed patients with far-lateral lumbar disc herniation (FLLDH) from June 2015 to October 2018. Twenty-six patients underwent paraspinal muscle-splitting microscopic-assisted discectomy (MD), and 30 underwent percutaneous endoscopic lumbar discectomy (PELD) surgery. Data included the duration of the operation, duration of intraoperative radiation exposure and average hospitalization. Pre- and postoperative pain scores and neurological functions were recorded using visual analogue scale (VAS) score and Oswestry disability index (ODI). Results A total of 56 patients remained in the study over the 12–24 months. The mean operating time was 65.83 ± 16.64 min in the PELD group, the mean duration of radiation exposure was 2.87±1.19 min and average hospitalization was 3.43 days. The mean operating time was 44.96 ± 16.87 min in the MD group, the mean duration of radiation exposure was 0.78±0.32 min and average hospitalization was 4.12 days. All patients in both groups showed significant improvement of VAS and ODI scores after surgery and until final follow-up. Conclusion Both techniques are minimally invasive, effective, and safe for treating far-lateral lumbar disc herniation in selected patients. Compared with the PELD technique, the MD procedure affords a wider field of vision during operation, shorter operation time, fewer postoperative complications, and a shorter learning curve.

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.

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