scholarly journals The Clinical Results of Percutaneous Endoscopic Interlaminar Discectomy (PEID) in the Treatment of Calcified Lumbar Disc Herniation: A Case-Control Study

2016 ◽  
Vol 19 (2;2) ◽  
pp. 69-75
Author(s):  
Fu Qiang
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Case Control Study ◽  
Lumbar Disc ◽  
Case Control ◽  
Lumbar Discectomy ◽  
Herniated Disc ◽  
Significant Difference ◽  
Endoscopic Lumbar Discectomy ◽  
Control Study

Background: Percutaneous endoscopic interlaminar discectomy (PEID), which poses advantages for certain types of herniated disc, is gaining wider acceptance in clinical practice. We retrospectively analyzed the efficacy of the PEID technique in treatment of calcified lumbar disc herniation. Study Design: A retrospective case-control study. Setting: University hospital in China. Objective: To evaluate the efficacy of the PEID technique in treatment of calcified lumbar disc herniation, and a comparison between calcified and noncalcified disc herniation was drawn to analyze the causes of herniated disc calcification. Methods: Data from patients who underwent full-endoscopic lumbar discectomy in our department between March 2011 and May 2013 were collected. Thirty cases with calcified lumbar disc herniation were included in the study group, and 30 age-, gender-, and body mass index (BMI)-matched cases with noncalcified lumbar disc herniation served as controls. Perioperative data, preoperative and postoperative Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) values, MacNab scores, and postoperative low-extremity dysesthesia among patients in the 2 groups were collected. Results: The values of computed tomography (CT) in the calcified group were significantly higher than those in the noncalcified group (P < 0.01). The preoperative disease courses in the 2 groups were similar. However, there was a statistically significant difference in the duration of traditional Chinese medicines (TCM) administration (P < 0.01). VAS and ODI scores improved significantly after surgery, but there were no significant differences between the 2 groups (P > 0.05). Three months after surgery, the rate of low-extremity dysesthesia in the calcified group was significantly higher than that in the control group (P = 0.03) but became similar at 6 months. By applying MacNab criteria the proportions of good and excellent were greater than 90% in both groups, and there was no difference between groups (P > 0.05). Limitations: The sample size was small in this retrospective study. Conclusion: The PEID technique is an effective method in the treatment of calcified lumber disc herniation, although the rate of postoperative dysesthesia is higher in this group during the early postoperative period. Long-term TCM administration may be related to the calcification of herniated lumbar discs. Key words: Lumbar disc herniation, percutaneous endoscopic lumbar discectomy, interlaminar approach, calcification

scholarly journals CHRNA5/CHRNA3 gene cluster is a risk factor for lumbar disc herniation: a case-control study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xuejun Yang ◽  
Xiaodong Guo ◽  
Zhi Huang ◽  
Yifeng Da ◽  
Wenhua Xing ◽  
...  
Keyword(s):  
Risk Factor ◽  
Gene Cluster ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Case Control Study ◽  
Lumbar Disc ◽  
Case Control ◽  
Control Study

Comparing the surgical efficacy of a newly designed endoscopic visualized trephine and a conventional trephine for percutaneous endoscopic lumbar discectomy with foraminoplasty for patients with single-segment lumbar disc herniation: A retrospective case -control study

2021 ◽  
Author(s):  
Shangbo Niu ◽  
Dehong Yang ◽  
Jie Li ◽  
Wenbo Diao ◽  
Jian Gao ◽  
...  
Keyword(s):  
Case Control Study ◽  
Lumbar Disc ◽  
Case Control ◽  
Single Segment ◽  
Significant Difference ◽  
Angular Displacements ◽  
Time Required ◽  
Endoscopic Lumbar Discectomy ◽  
Lumbar Extension ◽  
Control Study

Abstract Background Owing to the remarkable evolution of percutaneous endoscopic lumbar discectomy (PELD), the application of spinal endoscopy is shifting from the treatment of soft disk herniation to complex lumbar spinal stenosis. This study aim to compare the surgical efficacy of a newly designed endoscopic visualized trephine and a conventional trephine for PELD with foraminoplasty for patients with single-segment lumbar disc herniation (LDH). Methods A total of 54 patients who were diagnosed with single-segment LDH and received PELD with foraminoplasty at Xuzhou Central Hospital (Xuzhou, China) from January 2016 to June 2020 were included in this case-control study. Data related to the length of incision, amount of intraoperative bleeding, the time required to create the working channel, and intraoperative and postoperative complications were recorded. The Visual Analog Scale (VAS) score was used to assess low back pain and leg pain. Besides, the Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) scores were utilized to evaluate patients’ pain intensity and their sitting and standing abilities. The X-ray fluoroscopy was performed to measure the horizontal and angular displacements of lumbar extension-flexion, and to evaluate the stability of lumbar spine. Results All the patients successfully underwent surgical procedures, except for two patients with injuries in the spinal nerve root of the responsible segment in the conventional trephine group, who were given nutritional supplements for nerve treatment. Besides, there was no significant difference in incision length and operative blood loss between the modern trephine and the conventional trephine groups. However, the time required to create the channel and the duration of fluoroscopy in the modern trephine group were significantly less than those in the conventional trephine group (34.24 ± 5.38 vs. 44.76 ± 6.37 min, P < 0.05). In addition, the VAS, ODI, and JOA scores significantly decreased postoperatively in the two groups. We also found no significant difference in horizontal and angular displacements of lumbar extension-flexion between the two groups pre-operation and at 3- and 12-month post-operation. Conclusion In spite of similar surgical efficacy of the two techniques, the newly designed endoscopic visualized trephine outperformed in terms of operation time and duration of fluoroscopy.

scholarly journals Percutaneous Endoscopic Lumbar Discectomy as an Alternative to Open Lumbar Microdiscectomy for Large Lumbar Disc Herniation

2016 ◽  
Vol 19 (2;2) ◽  
pp. E291-E300 ◽  
Author(s):  
Jin-Sung Kim
Keyword(s):  
Back Pain ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Disc Height ◽  
Herniated Disc ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Endoscopic Lumbar Discectomy

Background: Remarkable advancements in endoscopic spinal surgery have led to successful outcomes comparable to those of conventional open surgery. Large lumbar disc herniation (LLDH) is a serious condition, resulting in higher surgical failure when accessing the herniated disc. Objectives: This study compared the outcomes of LLDH treated with percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM). Study Design: Retrospective assessment. Methods: This retrospective observational study was conducted from January 2011 to June 2012. Forty-four consecutive patients diagnosed with LLDH without cauda equina syndrome who were scheduled to undergo spinal surgery were included. LLDH was defined as herniated disc fragment occupying > 50% of the spinal canal. Clinical outcomes were evaluated using a visual analogue scale (VAS, 0 – 10), functional status was assessed using the Oswestry Disability Index (ODI, 0 – 100%) at 1, 6, and 24 months postoperatively and surgical satisfaction rate (0 – 100%) at final follow up. Radiological variables were assessed by plain radiography. Results: Forty-three patients were included; 20 and 23 patients underwent PELD and OLM, respectively. Both groups exhibited significant improvements in leg and back pain postoperatively (P < 0.001). Although there was no significant difference in leg pain improvement between the groups, improvement in back pain was significantly higher in the PELD group than in the OLM group (4.9 ± 1.5 vs. 2.5 ± 1.0, P < 0.001). The surgical satisfaction rate of the PELD group was significantly higher than that of the OLM group (91.3% ± 6.5 vs. 84.3% ± 5.2, P < 0.001). Mean operating time, hospital stay, and time until return to work were significantly shorter in the PELD group than in the OLM group (67.8 vs. 136.7 minutes, 1.5 vs. 7.2 days, and 4.2 vs. 8.6 weeks; P < 0.001). Disc height (%) decreased significantly from 23.7 ± 3.3 to 19.1 ± 3.7 after OLM (P < 0.001), but did not change significantly after PELD (23.6 ± 3.2 to 23.4 ± 4.2; P = 0.703). The segmental angle of the operated level increased from 10.3° to 15.4° in the PELD group, which was significantly higher than that in the OLM group (9.6° to 11.6°; P = 0.038). In the OLM group, there was one case of fusion due to instability. In the PELD group, one case required revision surgery and another case experienced recurrence. There were no perioperative complications in either group. Limitation: The study was retrospective with a small sample size and short follow-up period. Conclusion: PELD can be an effective treatment for LLDH, and it is associated with potential advantages, including a rapid recovery, improvements in back pain, and disc height preservation. Key words: Large lumbar disc herniation, percutaneous endoscopic lumbar discectomy, microdiscectomy, back pain, disc height

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.

scholarly journals Posterior percutaneous endoscopic lumbar discectomy combined with the vertical anchoring technique for lumbar disc herniation with distant upward migration

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yu Xia ◽  
Qiongyue Zhang ◽  
Xiang Gao ◽  
Keran Wang ◽  
Xun Zhang ◽  
...  
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Japanese Orthopaedic Association ◽  
Lumbar Discectomy ◽  
Herniated Disc ◽  
Upward Migration ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Endoscopic Lumbar Discectomy ◽  
Anchoring Technique

Abstract Background Posterior percutaneous endoscopic lumbar discectomy (PELD) has become a preferred procedure for the treatment of simple lumbar disc herniation (LDH) but has rarely been reported for distant upward migration. The purpose of this research was to investigate the feasibility, safety, clinical efficacy and technical points of posterior PELD combined with the vertical anchoring technique (VAT) for the treatment of LDH with distant upward migration. Methods Thirteen patients with distant upward migrated LDH who underwent posterior PELD combined with the VAT from March 2016 to May 2018 were selected. Among these cases, the herniated disc was located at L3/4 in 2 patients, L4/5 in 9 patients and L5/S1 in 2 patients. The operative time, length of hospital stay and postoperative complications were recorded. The visual analogue score (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores and modified MacNab criteria were used to assess surgical efficacy. Results All 13 patients underwent successful surgery. We compared the VAS, ODI and JOA scores before and after surgery. The differences were statistically significant (P < 0.05). According to the modified MacNab criteria, 10 patients were assessed as “excellent”, 2 patients were assessed as “good” and 1 patient was assessed as “fair” at the last follow-up. The rate of satisfactory outcomes was 92.3%. Conclusion Posterior PELD combined with the VAT is a safe and feasible procedure for the treatment of LDH with distant upward migration and represents a new approach for this type of surgery.

Predicting conservative treatment failure in patients with lumbar disc herniation. Single center, case-control study

2020 ◽  
Vol 193 ◽  
pp. 105867 ◽  
Author(s):  
Krzysztof Ostafiński ◽  
Wojciech Świątnicki ◽  
Jarosław Szymański ◽  
Anna Szymańska ◽  
Emilia Nowosławska ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Treatment Failure ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Case Control Study ◽  
Lumbar Disc ◽  
Case Control ◽  
Single Center ◽  
Control Study
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