scholarly journals Clinical Study of Hydraulic Perfusion Pump and Traditional Water Jet Irrigation for Percutaneous Endoscopic Lumbar Discectomy

2021 ◽  
Author(s):  
Jian wu ◽  
Yuehong Guan
Keyword(s):  
Visual Analog Scale ◽  
Lumbar Disc ◽  
Operation Time ◽  
Postoperative Recurrence ◽  
Water Jet ◽  
Analog Scale ◽  
Perfusion Pump ◽  
Pain Visual Analog Scale ◽  
Endoscopic Lumbar Discectomy

Abstract Objective: To compare clinical outcomes of hydraulic perfusion pump and traditional water jet irrigation in percutaneous endoscopic lumbar discectomy by a prospective randomized controlled study. Methods: From January 2016 to December 2018, 72 patients with lumbar disc herniation and failed conservative treatment were enrolled in this study. According to the odd number of the last digit of the hospitalization number, the patients were randomly divided into a hydraulic perfusion pump group and a traditional water jet irrigation group, 36 cases in each group. There were no significant differences in gender, age, prominent segment, clinical classification, preoperative pain visual analog scale (VAS), and Japanese Orthopedic Association (JOA) scores between two groups (P>0.05). The same surgeon performed all operations. These operations were performed by hydraulic perfusion pump flushing and traditional water flushing assisted surgery. The patients were followed up for 12 to 24 months (mean 15.7 months). The operation time, blood loss, hospital time, visual analog scale (VAS) for follow-up pain after one day and two weeks, and the last follow-up JOA scores. The type and incidence of postoperative complications were compared between two groups.Results: Compared with the traditional water flushing group, the operation time of the hydraulic perfusion pump group was short [(65.5±21.3) min vs. (74.8±19.9) min, t=9.465, P=0.003]. Blood loss was less [(21.2±12.9) ml vs. (27.4±14.1) ml, t=8.331, P=0.012]; there was no statistical difference in hospitalization time. The pain visual analog scale (VAS) and the last follow-up JOA scores in one day, two weeks were better than preoperative, but there was no statistical difference between the groups (P>0.05). In the traditional water flushing group, the symptoms of increased intracranial pressure like headache and neck pain occurred during the operation, which was forced to shorten the operation time in 5 cases, nerve root adventitia injury in 4 cases, and postoperative recurrence in 4 cases. In the hydraulic perfusion pump group, no patient had the symptoms of increased intracranial pressure like headache and neck pain, and nerve root adventitia injury in 1 case and 2 cases of postoperative recurrence. The incidence of complications in the hydraulic perfusion group was lower than that in the traditional water flow group. Conclusion：Hydraulic perfusion pump and traditional water-flow irrigation assisted percutaneous endoscopic lumbar disc herniation can achieve satisfactory clinical results. However, the former has short operation time, clear vision in operation, less bleeding, and less in-operation and postoperative complications.

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 Follow-up results of microendoscopic discectomy compared to day surgery using percutaneous endoscopic lumbar discectomy for the treatment of lumbar disc herniation

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhaojun Song ◽  
Maobo Ran ◽  
Juan Luo ◽  
Kai Zhang ◽  
Yongjie Ye ◽  
...  
Keyword(s):  
Back Pain ◽  
Blood Loss ◽  
Lumbar Disc ◽  
Postoperative Recurrence ◽  
Day Surgery ◽  
Lumbar Discectomy ◽  
Height Ratio ◽  
Microendoscopic Discectomy ◽  
Endoscopic Lumbar Discectomy

Abstract Background Percutaneous endoscopic lumbar discectomy (PELD) is satisfactory for hospitalized patients with lumbar disc herniation (LDH). Currently, only a few studies have reported about the day surgery patients undergoing PELD. Methods A total of 267 patients with LDH underwent PELD during day surgery and were followed up for at least 3 years. Clinical outcomes were assessed using the visual analog scale (VAS) for leg and lower back pain (VAS-B and VAS-L, respectively) and the Oswestry disability index (ODI). The radiological outcomes, such as lumbar lordosis (LL), sacral slope (SS), the disc-height ratio, and disc instability, were recorded and compared. The clinical effects between patients treated by PELD during day surgery and microendoscopic discectomy (MED) for contemporaneous hospitalized 116 patients with LDH were compared. Results Patients treated by PELD had lower blood loss and shorter hospital stay (P <  0.001) compared to those treated by MED. VAS-L, VAS-B, and ODI decreased significantly after PELD than before the operation and 3 years postoperatively. The postoperative VAS-B in the PELD group was significantly decreased than in the MED group (P = 0.001). The complications rate was 9.4% in the PELD group and 12.1% in the MED group (P = 0.471). The 1-year postoperative recurrence rate in the PELD group was much higher than that in MED group (P = 0.042). The postoperative LL and SS in the PELD group improved significantly compared to the values in the MED group (P <  0.001). According to the disc-height ratio at 3-year follow-up, a significant height loss was observed in the MED group than in the PELD group (P = 0.014). Conclusions Although the 1-year postoperative recurrence rate was relatively high, the day surgery for LDH undergoing PELD had advantages in terms of less blood loss intraoperatively, short hospital stay, efficacy for back pain, and efficiency to maintain lumbar physiological curvature.

Randomized Trial Comparing Self-Gripping Mesh with Polypropylene Mesh in Female Lichtenstein Hernioplasty

2020 ◽  
Vol 86 (2) ◽  
pp. 110-115
Author(s):  
Dianchen Wang ◽  
Hui Zhang ◽  
Ting Lei ◽  
Jianmin Chen ◽  
Yake Chen ◽  
...  
Keyword(s):  
Foreign Body ◽  
Visual Analog Scale ◽  
Short Form ◽  
Operation Time ◽  
Analog Scale ◽  
Lichtenstein Hernioplasty ◽  
Operative Outcomes ◽  
Significant Difference ◽  
One Year

Several randomized trials comparing self-gripping mesh with polypropylene (PL) mesh in Lichtenstein hernioplasty revealed that the self-gripping mesh significantly reduced the operation time. In these studies, some enrolled only male patients, and in others, the proportion of women was extremely low. The aim of this research was to compare outcomes after self-gripping mesh repair with PL mesh secured with sutures in female Lichtenstein hernioplasty. Female patients with primary unilateral inguinal hernia were assigned randomly to undergo Lichtenstein hernioplasty with a self-gripping ProGrip (PG) mesh or a sutured PL mesh, followed-up at one week, one month, three months, one year, and two years. Demographics, hernia characteristics, and operative outcomes data were analyzed. Pain was assessed with a visual analog scale (0–10), and quality of life (QOL) was estimated by a 36-item short-form general survey (0–26). Forty eight patients in the PG group and 51 participants in the PL group completed the follow-up. The operation time of the PG (54.1 ± 12 minutes) group was significantly shorter than that of the PL (60.9 ± 11.3 minutes) group ( P = 0.045). At the one-month follow-up, the incidence of foreign body feeling in the PG group was significantly higher than that in the PL group ( P = 0.031), whereas no significant difference was observed in visual analog scale ≥3 and QOL. In a follow-up of three months, one year, and two years, there was no significant difference in foreign body feeling, chronic pain, QOL, and recurrence between two groups. The surgical outcomes of self-gripping mesh are comparable to those of the ordinary PL mesh with a reduced operation time in female Lichtenstein hernioplasty. Registration number: ChiCTR1800017360 ( http://www.chictr.org.cn ).

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.

Treatment of recalcitrant viral warts using a 577-nm wavelength high-power optically pumped semiconductor laser

2016 ◽  
Vol 5 (3) ◽  
Author(s):  
Bianca Bigge ◽  
Stefan Bigge
Keyword(s):  
Semiconductor Laser ◽  
Visual Analog Scale ◽  
High Power ◽  
Genital Warts ◽  
Optically Pumped ◽  
Analog Scale ◽  
Invasive Treatment ◽  
Complete Clearance ◽  
Pain Visual Analog Scale

AbstractWe report the use of a 577-nm wavelength high-power optically pumped semiconductor laser (HOPSL) to treat 12 patients with multiple recalcitrant non-genital warts that had not responded to conservative and invasive treatment. The patients were treated weekly using a 577 nm HOPSL connected to a scanner device. Ten patients with warts showed complete clearance after treatment. One patient had partial clearance and one did not respond at all. Slight to medium pain (visual analog scale, VAS=2–6) was reported during treatment. After treatment there was no evidence of scarring. After the 6-month follow-up there was no recurrence of the completely cleared warts.

MIDTERM OUTCOME AFTER MICROENDOSCOPIC DECOMPRESSIVE LAMINOTOMY FOR LUMBAR SPINAL STENOSIS

Neurosurgery ◽  
2009 ◽  
Vol 65 (1) ◽  
pp. 100-110 ◽  
Author(s):  
Manuel Castro-Menéndez ◽  
Jose A. Bravo-Ricoy ◽  
Roberto Casal-Moro ◽  
Moisés Hernández-Blanco ◽  
Francisco J. Jorge-Barreiro
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Visual Analog Scale ◽  
Visual Analog Scale Score ◽  
Analog Scale ◽  
Oswestry Disability Index Score ◽  
Pain Visual Analog Scale ◽  
The Mean ◽  
Lumbar Spinal

ABSTRACT OBJECTIVE To evaluate the efficacy of radicular decompression in lumbar spinal stenosis using a microendoscopic technique. METHODS This was a longitudinal prospective study of 50 patients with a diagnosis of lumbar spinal stenosis who were treated by microendoscopic decompression using an 18-mm METRx tubular retractor according to the METRx technique (Medtronic Sofamor Danek, Memphis, TN). Twenty of the patients had an additional disc prolapse, and a microendoscopic discectomy was associated with decompressive laminectomy. The results were evaluated using the visual analog scale pain score, Oswestry Disability Index score, patient satisfaction questionnaire, and modified Macnab classification. RESULTS The average age of the patients was 56 years; 29 (58%) were men and 21 (42%) were women. The most commonly affected level was L4–L5 (64%). The mean surgical intervention time was 94.3 (± 14.3) minutes. Mean postoperative hospital stay was 3.16 (± 2.3) days. The follow-up time after surgery was 4 years (48 ± 6.6 months; range, 24–72 months). We obtained good or excellent results in 72% of patients, achieving good subjective satisfaction in 68% of the patients. The mean decrease in the Oswestry Disability Index score was 30.23 (± 24.29), the mean decrease in the leg pain visual analog scale score was 6.02 (± 2.57), and the mean decrease in the lumbar pain visual analog scale score was 0.84 (± 2.06). Adjusted mean differences were in all cases statistically significant (P &lt;0.05). CONCLUSION Data indicate that, in our experience, on midterm follow-up, microendoscopic laminectomy decompression is an effective technique for the treatment of lumbar spinal stenosis.

scholarly journals Microscopic extra-laminar sequestrectomy (MELS) for the treatment of hidden zone lumbar disc herniation: report of the surgical technique, patient selection, and clinical outcomes

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chunxiao Wang ◽  
Yao Zhang ◽  
Xiaojie Tang ◽  
Haifei Cao ◽  
Qinyong Song ◽  
...  
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operation Time ◽  
Operation Duration ◽  
The Mean

Abstract Background The area which located at the medial pedicle, posterior vertebral body and ventral hemilamina is defined as the hidden zone. Surgical management of hidden zone lumbar disc herniation (HZLDH) is technically challenging due to its difficult surgical exposure. The conventional interlaminar approach harbors the potential risk of post-surgical instability, while other approaches consist of complicated procedures with a steep learning curve and prolonged operation time. Objective To introduce microscopic extra-laminar sequestrectomy (MELS) technique for treatment of hidden zone lumbar disc herniation and present clinical outcomes. Methods Between Jan 2016 to Jan 2018, twenty one patients (13 males) with HZLDH were enrolled in this study. All patients underwent MELS (19 patients underwent sequestrectomy only, 2 patients underwent an additional inferior discectomy). The nerve root and fragment were visually exposed using MELS. The operation duration, blood loss, intra- and postoperative complications, and recurrences were recorded. The Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and the modified MacNab criteria were used to evaluate clinical outcomes. Postoperative stability was evaluated both radiologically and clinically. Results The mean follow-up period was 20.95 ± 2.09 (18–24) months. The mean operation time was 32.43 ± 7.19 min and the mean blood loss was 25.52 ± 5.37 ml. All patients showed complete neurological symptom relief after surgery. The VAS and ODI score were significantly improved at the final follow-up compared to those before operation (7.88 ± 0.70 vs 0.10 ± 0.30, 59.24 ± 10.83 vs 11.29 ± 3.59, respectively, p < 0.05). Seventeen patients (81%) obtained an “excellent” outcome and the remaining four (19%) patients obtained a “good” outcome based the MacNab criteria. One patient suffered reherniation at the same level one year after the initial surgery and underwent a transforaminal endoscopic discectomy. No major complications and postoperative instability were observed. Conclusions Our observation suggest that MELS is safe and effective in the management of HZLDH. Due to its relative simplicity, it comprises a flat surgical learning curve and shorter operation duration, and overall results in reduced disturbance to lumbar stability.

scholarly journals Investigation of the Correlation between Postherpetic Itch and Neuropathic Pain over Time

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Rie Ishikawa ◽  
Masako Iseki ◽  
Rie Koga ◽  
Eiichi Inada
Keyword(s):  
Neuropathic Pain ◽  
Herpes Zoster ◽  
Pain Intensity ◽  
Visual Analog Scale ◽  
Analog Scale ◽  
Paindetect Questionnaire ◽  
Relationship Of ◽  
The Relationship ◽  
Over Time

Postherpetic itch (PHI), or herpes zoster itch, is an intractable and poorly understood disease. We targeted 94 herpes zoster patients to investigate their pain and itch intensities at three separate stages of the condition (acute, subacute, and chronic). We used painDETECT questionnaire (PDQ) scores to investigate the correlation between PHI and neuropathic pain. Seventy-six patients were able to complete follow-up surveys. The prevalence of PHI was 47/76 (62%), 28/76 (37%), and 34/76 (45%) at the acute, subacute, and chronic stages, respectively. PHI manifestation times and patterns varied. We investigated the relationship of PHI with neuropathic pain using the visual analog scale (VAS), which is a measure of pain intensity, and the PDQ, which is a questionnaire used to evaluate the elements of neuropathic pain. The VAS and PDQ scores did not differ significantly between PHI-positive and PHI-negative patients. A large neuropathic component was not found for herpes zoster itch, suggesting that neuropathic pain treatments may not able to adequately control the itch. Accordingly, we suggest that a more PHI-focused therapy is required to address this condition.

Burst Spinal Cord Stimulation

Neurosurgery ◽  
2010 ◽  
Vol 66 (5) ◽  
pp. 986-990 ◽  
Author(s):  
Dirk De Ridder ◽  
Sven Vanneste ◽  
Mark Plazier ◽  
Elsa van der Loo ◽  
Tomas Menovsky
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Visual Analog Scale ◽  
Spinal Cord Stimulation ◽  
Short Form ◽  
Burst Stimulation ◽  
Analog Scale ◽  
Tonic Stimulation ◽  
Better Than

Abstract INTRODUCTION Spinal cord stimulation is commonly used for neuropathic pain modulation. The major side effect is the onset of paresthesia. The authors describe a new stimulation design that suppresses pain as well as, or even better than, the currently used stimulation, but without creating paresthesia. METHODS A spinal cord electrode (Lamitrode) for neuropathic pain was implanted in 12 patients via laminectomy: 4 at the C2 level and 7 at the T8–T9 level for cervicobrachialgia and lumboischialgia, respectively (1 at T11 at another center). During external stimulation, the patients received the classic tonic stimulation (40 or 50 Hz) and the new burst stimulation (40-Hz burst with 5 spikes at 500 Hz per burst). RESULTS Pain scores were measured using a visual analog scale and the McGill Short Form preoperatively and during tonic and burst stimulation. Paresthesia was scored as present or not present. Burst stimulation was significantly better for pain suppression, by both the visual analog scale score and the McGill Short Form score. Paresthesia was present in 92% of patients during tonic stimulation, and in only 17% during burst stimulation. Average follow-up was 20.5 months. CONCLUSION The authors present a new method of spinal cord stimulation using bursts that suppress neuropathic pain without the mandatory paresthesia. Pain suppression seems as good as or potentially better than that achieved with the currently used stimulation. Average follow-up after nearly 2 years (20.5 months) suggests that this stimulation design is stable.

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