scholarly journals A Retrospective Comparative Study of Local Anesthesia Only and Local Anesthesia with Sedation for Percutaneous Endoscopic Lumbar Discectomy

2021 ◽  
Author(s):  
Liu Yang ◽  
Yu-Lin Pan ◽  
Chun-Zhi Liu ◽  
De-Xin Guo ◽  
Xin Zhao
Keyword(s):  
Clinical Outcomes ◽  
Local Anesthesia ◽  
Lumbar Discectomy ◽  
Control Group ◽  
Surgical Experience ◽  
Lumbar Disk Herniation ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Retrospective Comparative Study ◽  
Endoscopic Lumbar Discectomy ◽  
Surgical Duration

Abstract The purpose of this study was to compare surgical experience and clinical outcomes of lumbar disk herniation (LDH) patients treated with percutaneous endoscopic lumbar discectomy (PELD) using local anesthesia only and local anesthesia with sedation. Ninety-two consecutive LDH patients were divided into four groups: control group (Con Group), dexmedetomidine group (Dex Group), oxycodone group (Oxy Group), and dexmedetomidine + oxycodone group (Dex + Oxy Group). Mean arterial pressure (MAP), heart rate (HR), Ramsay score and VAS score were compared before anesthesia (T1), working cannula establishment (T2), nucleus pulposus removal (T3), and immediately postoperative (T4). Surgical duration, hospitalization and MacNab criteria were evaluated. In control group, MAP and HR at T2 and T3 were higher than T1 (P < 0.05). In Dex, Oxy, and Dex + Oxy groups, MAP and HR at T2, T3, T4 were lower than T1, but Ramsay scores at T2, T3, T4 were higher than T1 (P < 0.05). VAS scores in all groups were improved postoperative (p>0.05). The clinical outcomes have no significant differences among the four groups (P > 0.05). We concluded that the combination of dexmedetomidine and oxycodone under local anesthesia is an effective method to improve surgical experience and reduce anxiety in suitable LDH patients.

scholarly journals Comparison of Percutaneous Endoscopic Lumbar Discectomy and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Revision Surgery for the Recurrent Lumbar Disc Herniation After Percutaneous Endoscopic Lumbar Discectomy

2020 ◽  
Author(s):  
Anqi Wang ◽  
Zhengrong Yu
Keyword(s):  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Revision Surgery ◽  
Lumbar Disc ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Surgical Methods ◽  
Endoscopic Lumbar Discectomy

Abstract Background: Percutaneous endoscopic lumbar discectomy (PELD) has become a feasible alternative to the conventional open surgery for the treatment of lumbar disc herniation (LDH), but PELD is associated with a certain rate of recurrence. Therefore, a good choice of surgical approach for recurrent lumbar disc herniation (rLDH) is important. The purpose of this study was to compare the outcomes between PELD and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for revision surgery for the rLDH after primary PELD surgery.Methods: This study retrospectively assessed 46 patients who suffered from rLDH after PELD surgery in Peking University First Hospital from January 2015 to June 2019, and patients were divided into two groups, PELD group (n=24) and MIS-TLIF group (n=22), according to different revision surgical methods. Preoperative data, perioperative conditions, complications, recurrence condition, and clinical outcomes were compared between these two groups.Results: Compared with the MIS-TLIF group, the PELD group was associated with shorter operative time, less intraoperative hemorrhage, and shorter post-operative hospitalization, but higher recurrence rate. Complication rates were comparable between two groups. Both the two groups could provide patients with satisfactory clinical outcomes at the 12-month follow-up after revision surgery. Compared with MIS-TLIF, PELD was associated with visual Analog Scale (VAS) scores of back pain, and Oswestry disability index (ODI) at the 1-month follow-up, whereas this effect was equalized after 6 months postoperatively.Conclusions: Either PELD or MIS-TLIF surgery could provide satisfactory clinical outcomes for revision surgery for the rLDH after primary PELD. PELD brought advantages in shorter operative time, less intraoperative hemorrhage, and shorter post-operative hospitalization over MIS-TLIF, however, higher postoperative recurrence rate of PELD couldn’t be ignored. Surgeons must weigh advantages against disadvantages of these surgical methods and fully informed patients preoperatively.

Clinical Outcomes of Lateral Lumbar Interbody Fusion Combined with Percutaneous Endoscopic Lumbar Discectomy During the Treatment of Low-grade Spondylolisthesis

2020 ◽  
Author(s):  
Jiaqi Li ◽  
Yapeng Sun ◽  
Wei Zhang ◽  
Fei Zhang ◽  
Lei Guo ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Lumbar Discectomy ◽  
Low Grade ◽  
Lumbar Interbody Fusion ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Lateral Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Endoscopic Lumbar Discectomy

Abstract Background Minimally invasive lateral lumbar interbody fusion (LLIF) in combination with percutaneous endoscopic lumbar discectomy (PELD) can achieve interbody fusion and direct decompression, but their combined use has not been widely reported. In this study, the clinical outcomes of LLIF in combination with PELD in low-grade spondylolisthesis was evaluated, particularly in cases of a requirement for direct decompression. Methods Patients with single-level low-grade spondylolisthesis, undergoing LLIF in combination with PELD were included. The severity of lower back and leg pain was reported using visual analog scale (VAS). The Oswestry disability index (ODI) was used to evaluate functional improvements of patients. A comparison of preoperative and postoperative indicators was performed through repeated measures of analysis of variance. P < 0.05 was considered as a statistically significant difference. Results A total of 48 patients (20 males and 28 females) were included. The intraoperative blood loss was 112.60ml ± 43.69 and the average operation time was 116.35min ± 22.31. VAS and ODI were significantly improved in all stages after operation. The fusion rate at the final follow-up was 93.7%. No injuries occurred to the vessels, nerves and organs during the perioperative period. Conclusions LLIF in combination with PELD achieved adequate decompression and intervertebral fusion, with precise and reliable clinical outcomes. In addition, the procedure was minimally invasive, resulting in small tissue injury and rapid postoperative recovery. Multi-center prospective comparative studies are now needed to further confirm the superiority of this combination.

scholarly journals State of the Art: Transforaminal Approach for Percutaneous Endoscopic Lumbar Discectomy under Local Anesthesia

2014 ◽  
Vol 61 (3.4) ◽  
pp. 217-225 ◽  
Author(s):  
Koichi Sairyo ◽  
Hiroshi Egawa ◽  
Tetsuya Matsuura ◽  
Mitsuhiko Takahashi ◽  
Kosaku Higashino ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
State Of The Art ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Transforaminal Approach ◽  
Endoscopic Lumbar Discectomy
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