Transforaminal Percutaneous Endoscopic Discectomy in the Treatment of Adolescent Lumbar Disc Herniations With Posterior Ring Apophysis Separation

Mapping Intimacies ◽

10.21203/rs.3.rs-873681/v1 ◽

2021 ◽

Author(s):

changkun zheng ◽

Zhong Liao

Keyword(s):

Daily Living ◽

Lumbar Disc ◽

Outcome Data ◽

Clinical Assessments ◽

Endoscopic Discectomy ◽

Disc Herniations ◽

Motor Strength ◽

Poor Outcomes ◽

Posterior Ring

Abstract Objective: To assess the efficacy of transforaminal percutaneous endoscopic discectomy in the treatment of adolescent lumbar disc herniations with posterior ring apophysis separation Methods: Overall 23 cases of adolescent lumbar disc herniations with posterior ring apophysis separation were treated with the procedure of transforaminal percutaneous endoscopic discectomy between January 2016 and December 2019. Preoperative and postoperative (6 week, 6 month and 12 month) clinical outcome data (back and leg VAS and Macnab criteria) were collected along with clinical assessments of motor strength (graded 0-5).Results All patients were discharged to home on the same day of surgery. The average leg Visual Analog Scale improved from 8.7 ± 1.5 to 2.0± 0.5 (p < 0.005). Fifteen patients had excellent outcomes, six had good outcomes, two had fair outcomes, and no had poor outcomes, according to the Macnab criteria. Ten of eleven patients had excellent or good outcomes, for an overall success rate of 91.3%. No patients required reoperation. There were no incidental durotomies, infections, vascular or visceral injuries. There was 1 complication, a case of leg numbness caused by ganglion injury. The numbness improved after 3 weeks. After 2 months, it was obvious that the total area of numbness in the legs had become smaller. At last follow-up, the patient had no pain, and only a few areas with numbness remained and did not affect the patient’s activities of daily living. Conclusion:Transforaminal percutaneous endoscopic discectomy achieve satisfactory results for adolescent lumbar disc herniations with posterior ring apophysis separation.

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Minimally invasive direct lateral, retroperitoneal transforaminal approach for large L1–2 disc herniations with intraoperative CT navigational assistance: technical note and report of 3 cases

Journal of Neurosurgery Spine ◽

10.3171/2017.11.spine17509 ◽

2018 ◽

Vol 29 (1) ◽

pp. 46-53 ◽

Cited By ~ 5

Author(s):

Adetokunbo A. Oyelese ◽

Jared Fridley ◽

David B. Choi ◽

Albert Telfeian ◽

Ziya L. Gokaslan

Keyword(s):

Lumbar Disc ◽

Technical Note ◽

Neurological Injury ◽

Ct Guided ◽

Intraoperative Ct ◽

Transforaminal Approach ◽

Endoscopic Discectomy ◽

Disc Herniations ◽

Poor Outcomes ◽

Lower Lumbar

Upper lumbar (L1–2, L2–3) disc herniations are distinct in their diffuse presenting clinical symptomatology and have poorer outcomes with surgical intervention than those following mid and lower lumbar disc herniations and disc surgery. The authors present the cases of 3 patients with L1–2 disc herniations and significant stenosis of the spinal canal. The surgical approach used here combined the principles of transforaminal percutaneous endoscopic discectomy and the extreme lateral lumbar interbody fusion procedures with intraoperative CT-guided navigational assistance. The approach provides a safe corridor of direct visualization to the ventral thecal sac with minimal bony resection and could, in principle, reduce neurological injury and biomechanical instability, which likely contribute to poor outcomes at this level.

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Outcomes of Discectomy in Young Adults With Large Central Lumbar Disc Herniations Presenting With Predominant Leg Pain

Global Spine Journal ◽

10.1177/2192568219856871 ◽

2019 ◽

Vol 10 (4) ◽

pp. 412-418

Author(s):

Arvind G. Kulkarni ◽

Sandeep Tapashetti

Keyword(s):

Young Adults ◽

Back Pain ◽

Lumbar Disc ◽

Young Patients ◽

Visual Analogue Score ◽

Leg Pain ◽

Disc Herniations ◽

The Mean ◽

Poor Outcomes

Study Design: Retrospective cohort study. Objectives: Discectomy alone or discectomy with fusion have been 2 polarized options in the management of large lumbar disc herniations presenting with leg-dominant pain in young patients. The objective of the study was to evaluate the outcomes of discectomy in young patients with large central lumbar disc herniation (CLDH) presenting with predominant leg pain. Material and Methods: Young patients (<45 years) presenting with predominant leg pain and MRI confirmed diagnosis of CLDH between April 2007-January 2017 were included in the study. All patients underwent tubular microdiscectomy. Outcomes of surgery were evaluated using visual analogue score (VAS) for leg and back pain, Oswestry Disability Index (ODI), and Macnab’s criteria. Results: Ninety patients fulfilled the inclusion criteria. The mean age of patients was 34.9 years (range 19-45 years). Mean follow-up was 5.09 years (range 2-10 years). The incidence of CLDH in young adults was 30% and incidence among all “operated” lumbar disc herniations was 15.9%. The mean VAS for leg pain improved from 7.48 ± 0.9 to 2.22 ± 0.84 ( P < .05) and the mean ODI changed from 60.53 ± 7.84 to 18.33 ± 6.20 ( P < .05). Fifty-nine patients (65.6%) reported excellent, 25 patients (27.8%) reported good, 3 patients each (3.3%) as fair and poor outcomes respectively. Conclusion: Discectomy alone for CLDH with predominant leg pain is associated with high success rate and low need for a secondary surgical procedure. Patient selection in terms of leg-dominant pain may be the main attribute for lower incidence of recurrence, postoperative back-pain, and instability needing a secondary procedure. Minimally invasive discectomy may provide an added advantage of preserving normal spinal anatomy, thus minimizing the need for primary spinal fusion in these patients.

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Long-term follow-up of standard microdiscectomy versus minimal access surgery for lumbar disc herniations

Acta Neurochirurgica ◽

10.1007/s00701-013-1901-z ◽

2013 ◽

Vol 155 (12) ◽

pp. 2333-2338 ◽

Cited By ~ 11

Author(s):

J. Gempt ◽

M. Jonek ◽

F. Ringel ◽

A. Preuß ◽

P. Wolf ◽

...

Keyword(s):

Lumbar Disc ◽

Minimal Access Surgery ◽

Minimal Access ◽

Long Term Follow Up ◽

Disc Herniations ◽

Access Surgery

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Five Cases of Lumbar Disc Herniations with Apparent Radiculopathy showing Resolution on Follow-up MRI Studies

Japanese Journal of Neurosurgery ◽

10.7887/jcns.7.671 ◽

1998 ◽

Vol 7 (11) ◽

pp. 671-677

Author(s):

Hiroshi Suzui ◽

Junya Hanakita ◽

Hideyuki Suwa

Keyword(s):

Lumbar Disc ◽

Mri Studies ◽

Disc Herniations

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The natural history of lumbar disc herniations assessed by a CT follow-up study

Proceedings of the XIV Symposium Neuroradiologicum ◽

10.1007/978-3-642-49329-4_27 ◽

1991 ◽

pp. 84-85 ◽

Cited By ~ 1

Author(s):

Kurt Pardatscher ◽

D. L. Fiore ◽

A. Barbiero

Keyword(s):

Natural History ◽

Lumbar Disc ◽

Follow Up Study ◽

Disc Herniations ◽

History Of

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

10.21203/rs.2.15446/v1 ◽

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.

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Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.165426 ◽

2016 ◽

Vol 7 (01) ◽

pp. 87-90 ◽

Cited By ~ 3

Author(s):

Serdal Albayrak ◽

Sait Ozturk ◽

Emre Durdag ◽

Ömer Ayden

Keyword(s):

Quality Of Life ◽

Facet Joint ◽

Lumbar Disc ◽

Life Quality ◽

Early Period ◽

Long Term Results ◽

Disc Herniations

ABSTRACT Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results.

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