scholarly journals Long term results of Endoscopic Lumbar Discectomy using Side viewing Conical working tube

2018 ◽  
Vol 32 (2) ◽  
pp. 306-313
Author(s):  
Mohammad Kaif ◽  
Kuldeep Yadav ◽  
Mazhar Husain

Abstract Object: Endoscopic discectomy is a common procure performed worldwide with various devices being used and studies have reported their long term results. In this study we present the long term results of the unique device with separate side viewing channel. Methods: 66 patients of lumbar disc herniation treated between March 2009 to April 2012 using the unique conical working tube with separate side viewing endoscopic channel. Their preoperative and postoperative Oswestry Disability Index (ODI) and Macnab scores were used to evaluate the outcome after a minimum follow of 5 years with mean follow up of 76.18 months. Results: There were 46 males and 20 females with age ranging from19-72 (mean-38.4 years). The follow up ranged from 61 months to 95 months with mean of 76.18 months. The mean preoperative ODI score was 74.7 which decreased to a mean of 7.8 and the outcome evaluated by Macnab criteria was 69.69% excellent, 17 % good, 10% fair, 3.03% poor. 2 patients underwent second surgery. None of the patient had to change their occupation due to their lumbar disc disease. Complications occurred were dural tear in 2 patients, transient foot paresis in 1 patient and 1 discitis in 1 patient which improved on medical management. Conclusion: Endoscopic discectomy using thins Conical working tube is a safe and effective technique for lumbar disc prolapse. It has the advantage for early mobilization, short hospital stay and low cost. The long term results are comparable to the conventional techniques.

Author(s):  
Mohammad Kaif ◽  
Kuldeep Yadav ◽  
Khursheed Alam Khan ◽  
Rakesh Kumar ◽  
Deepak Kumar Singh ◽  
...  

Abstract Objective The paradigm of surgical therapy for spinal disease especially for lumbar disc herniation (LDH) has gradually shifted from the traditional open surgeries to minimal invasive spinal surgeries. Endoscopic discectomy has been performed widely using various devices and techniques. In this study we present our experience of endoscopic discectomy using a unique device with separate side-viewing channel. Methods Twenty-six patients with LDH treated between March 2015 and April 2018 using the unique conical working tube with separate side-viewing endoscopic channel have been retrospectively analyzed. Their preoperative and postoperative Oswestry Disability Index (ODI) and Macnab scores were used to evaluate the outcome with a mean follow-up of 37.04 months. Results There were 18 males and 8 females with age ranging from 19 to 72 years (mean, 38.4 years). The follow-up ranged from 25 to 60 months with mean of 37.04 months. The mean preoperative ODI score was 72.4, which decreased to a mean of 7.6 and the outcome evaluated by Macnab criteria was 65.3% excellent, 19.2% good, 11.5% fair, and 3.8% poor. One patient underwent second surgery. None of the patients had to change their occupation postoperatively. Complications that occurred were dural tear in one patient and transient foot paresis in one, which improved spontaneously. Conclusion Endoscopic discectomy using conical working tube is a safe and effective technique for lumbar disc prolapse. The long-term results are comparable to the conventional techniques.


2021 ◽  
pp. 108-113
Author(s):  
Mohammad Kaif ◽  
Kuldeep Yadav ◽  
Rakesh Kumar ◽  
Deepak Kumar Singh

Objective: The paradigm of surgical therapy for spinal disease especially for lumbar disc herniation has gradually shifted from traditional open surgeries to minimally invasive spinal surgeries. Endoscopic discectomy has been performed widely using various devices and techniques. In this study, we present our experience of endoscopic discectomy using a unique device with separate side viewing channel. Methods: 26 patients of lumbar disc herniation treated between March 2015 to April 2018 using the unique conical working tube with separate side-viewing endoscopic channel have been retrospectively analysed. Their preoperative and postoperative Oswestry Disability Index (ODI) and Macnab scores were used to evaluate the outcome with a mean follow up of 37.04 months. Results: There were 18 males and 08 females with age ranging from 19-72 years (mean-38.4 years). The follow up ranged from 25 months to 60 months with a mean of 37.04 months. The mean preoperative ODI score was 72.4 which decreased to a mean of 7.6 and the outcome evaluated by Macnab criteria was 65.3% excellent, 19.2 % good, 11.5% fair, 3.8% poor. 1 patient underwent a second surgery. None of the patients had to change their occupation postoperatively. Complications occurred were dural tear in 1 patient and transient foot paresis in 1 which improved spontaneously. Conclusion: Endoscopic discectomy using conical working tube is a safe and effective technique for lumbar disc prolapse. The long term results are comparable to conventional techniques.


1986 ◽  
Vol 65 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Robert J. Maciunas ◽  
Burton M. Onofrio

✓ The long-term clinical outcome is evaluated for 268 patients after chymopapain chemonucleolysis for radicular complaints referrable to documented intervertebral disc disease. The follow-up period for 92% of these patients was 10 years. No complications due to chymopapain toxicity were observed; 80.1% of patients were relieved of their presenting radicular leg pain and 75.1% were employed at a capacity equal to or more strenuous than before injection. Chemonucleolysis was demonstrated to be a safe and effective treatment modality, with long-term results that compare favorably with those of similarly selected patients undergoing open surgical procedures. In the patients whose chymopapain therapy failed, the outcome of subsequent open surgical procedures was not necessarily compromised by prior chemonucleolysis. A higher rate of failure and subsequent surgical intervention was seen in those patients with injections performed soon after an unsuccessful open procedure on the same side and at the same interspace, those with workmen's compensation or litigation pending, those with a history of work-related injury, those whose employment involved heavy manual labor or extensive driving, and those whose preinjection spine x-ray films indicated retrograde spondylolisthesis.


2019 ◽  
Vol 3 (22;3) ◽  
pp. 295-304
Author(s):  
Yong Ahn

Background: Transforaminal endoscopic lumbar discectomy (TELD) is regarded as an effective treatment option for soft lumbar disc herniation (LDH). There have been few studies evaluating the long-term outcomes of endoscopic procedures compared with conventional surgery. Objectives: The objective of this study was to demonstrate the clinical outcomes of TELD compared with those of open lumbar microdiscectomy. Study Design: Between January 2009 and September 2011, 335 consecutive patients with symptomatic LDH were treated with decompressive discectomy, either TELD or open microdiscectomy. Patients were prospectively entered into the clinical database and their records were retrospectively reviewed. Setting: Hospital and outpatient surgical center. Methods: Data from 298 patients who were treated with decompressive discectomy, either TELD or open microdiscectomy, were evaluated with a minimum 5-year follow-up period. Among them, 146 patients were treated using TELD (TELD group), and the remaining 152 patients using open microdiscectomy (Open group). Perioperative data and clinical outcomes were evaluated using the visual analog scale (VAS), the Oswestry Disability Index (ODI), and the modified Macnab criteria. Results: The VAS and ODI significantly improved in both groups. The rate of excellent or good outcomes was 88.36% and 87.5% in the TELD and Open group, respectively. The reoperation rate was 4.2% and 3.3% in the TELD and Open group, respectively. There were no significant differences in the clinical outcomes; however, operative time, hospital stay, and time to return to work were significantly shorter in the TELD group (P < 0.01). Limitations: First, the patient selection was not randomized; therefore, the risk of bias might be increased. Second, this study lacks analysis of the radiographic changes related to the degenerative change over the long-term follow-up period. Conclusions: The long-term results of TELD for soft LDH are comparable to those of conventional open microdiscectomy. The selective endoscopic discectomy technique under local anesthesia provides the typical advantages of minimally invasive procedures such as a shorter operation time, hospital stay, and recovery time. Key words: Endoscopic, discectomy, hospital stay, lumbar disc, microscopic, operative time, return to work, transforaminal


2016 ◽  
Vol 7 (01) ◽  
pp. 87-90 ◽  
Author(s):  
Serdal Albayrak ◽  
Sait Ozturk ◽  
Emre Durdag ◽  
Ömer Ayden

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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