Application Value of Percutaneous Transluminal Intervertebral Foramen Endoscopy in the Treatment of Lumbar Disc Herniation

2021 ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Song Yan ◽  
Tian Taotao ◽  
Yun Shunwei ◽  
Li Haitao ◽  
Chang Cheng

Lumbar disc herniation is a common lumbar disease in clinics, which is related to improper use of lumbar vertebrae and osteoporosis. Surgical removal of nucleus pulposus and maintenance of lumbar structural stability are important for the treatment of lumbar disc herniation. At present, in clinical percutaneous intervertebral foramen endoscopic surgery for lumbar disc herniation, interlaminar and intervertebral foramen approaches can be selected. Different approaches have different degrees of difficulty in the treatment of lumbar disc herniation, and the clinical effects that may be obtained are different. In this study, we observed the influencing factors of plasma nitric oxide (NO) and free radical metabolism in patients with lumbar disc herniation and the correlation between the effects of focus separation. The organic combination of local and total illness differentiation and dialectics, conventional acupuncture, and electrical stimulation was highlighted in this study, which linked local acupoints squeezed by nerve roots with distant acupoints along meridians. The use of authoritative quantitative standards and a multifactor assessment of the disease can accurately represent the disease's severity. The patient's condition changes in each period may be expressed more accurately, thoroughly, and objectively through the rise or reduction of the score, making self-evaluation easier for the patient. Electroacupuncture at point may be one of the most important strategies to minimize free radical damage, based on changes in plasma levels.


2021 ◽  
Author(s):  
Ao-lin Yuan ◽  
Xin Shen ◽  
Bin Chen

Abstract Background: The percutaneous intervertebral foramen mirror technology is a new solution for lumbar disorders. However, like other minimally-invasive treatments for calcified lumbar discs, it is still controversial. The aim of this study was to investigate the use of the percutaneous intervertebral foramen lens technology for secondary molding of the intervertebral foramen in the treatment of calcified lumbar discs. Methods: The study included 50 patients aged (mean ± standard deviation) 49.9 ± 14.5 years, 30 (60%) females, who were diagnosed with calcified lumbar disc herniation by computed tomography and magnetic resonance imaging. Patients underwent a percutaneous endoscopic lumbar discectomy surgery in our hospital from January 1, 2017 to December 31, 2019. Demographic characteristics before the surgery and perioperative outcomes were retrospective reviewed. The treatment outcome was analyzed using the visual analog scale (VAS) score, the Oswestry Disability Index score, and modified Macnab criteria. Results: We evaluated those patients who showed significant improvement in both the VAS and ODI scores after the surgery and maintained relatively low ODI and VAS scores during subsequent follow-ups. Ninety-four percent of patients rated the results as "excellent" or "good" according to the modified Macnab criteria at the 3-month follow-up. One patient developed neck pain during the surgery, which was diagnosed as spinal hypertension syndrome, and the surgery was suspended until the patient improved. No patient had a dural leak, infection, or other related complications. Conclusions: Our results indicate that transforaminal remolding is effective in the treatment of calcified lumbar disc herniations, with few intraoperative and postoperative complications.Our results indicate that secondary reconstruction of the intervertebral foramen under visual conditions using microscopic knife is an effective method for treating calcified lumbar disc herniation, with few intraoperative and postoperative complications.


2021 ◽  
Author(s):  
wang shunmin ◽  
kaiqiang sun ◽  
aigang liu ◽  
rongzi chen ◽  
xi luo ◽  
...  

Abstract Background To compare the clinical outcomes of transforaminal lumbar interbody fusion (TLIF) and endoscopic discectomy in the treatment of postoperative adjacent segment degeneration in patients with lumbar disc herniation. Methods From 2014 to 2017, 87 patients who were diagnosed with single-level lumbar disc herniation (LDH) and received surgery of TLIF (group X, n = 43) or endoscopic discectomy (group F, n = 44) were retrospectively analyzed. X-ray, MRI, CT and clinical symptoms were recorded before operation and at the last follow-up. The neurological function was originally evaluated by the (JOA) score of the Japanese Orthopaedic Association. Radiological evaluation included the height of intervertebral space (HIS), intervertebral foramen height (FH), intervertebral foramen area (FA), lumbar lordosis (CA) and intervertebral disc degeneration pfirrmann score.Results There was no significant difference in average operation age, JOA improvement rate, reoperation rate and complications between the two groups. The average blood loss, average hospital stays and average operation time in group F were lower than those in group X. During the last follow-up, HIS, CA and FA decreased in both groups, and the changes in group X were more significant than those in group X (P < 0.05). There was no significant difference in postoperative FH between the two groups, but it decreased more in group X (P < 0.05).Conclusion Both TLIF and endoscopic surgery can achieve good results in the treatment of LDH, but the risk of lumbar adjacent segment degeneration after intervertebral foraminal surgery is lower.


2019 ◽  
Vol 9 (8) ◽  
pp. 1776-1781
Author(s):  
Zhaowen Peng ◽  
Wenwen Zhao ◽  
Shaohua Hu

Objective: Lumbar disc herniation leads the numbness and pain in the waist and lower limbs. Intervertebral foramen endoscopy is a minimally invasive procedure for the treatment of disc herniation. Adequate preoperative evaluation is conducive to this percutaneous skin surgery. The purpose of this study is to improve the efficacy of intervertebral foramen endoscopy in the treatment of lumbar disc herniation by preoperative computer three-dimensional reconstruction combined with pain management. Method: Fifty patients with lumbar disc herniation who met the indications of intervertebral foramen endoscopy were randomly divided into experimental group and control group. The control group was operated according to experience based on the common axial image. The experimental group was punctured according for three-dimensional visualization model of lumbar spine. Preoperative simulated puncture catheterization and perioperative pain management was applied. The catheterization time, operation time under endoscopy, fluoroscopy times during operation, the Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) scores before and 1 d, 1 m and 3 m after operation were compared between two groups. Result: The three-dimensional visualization model of lumbar spine was reconstructed based on thin-layer data. According to the results of software measurement, the skin puncture point was located and the puncture angle was obtained. Compared with the control group, the catheterization time, operation time under endoscopy, fluoroscopy times during operation in experimental group were significantly reduced. There was no statistical difference in VAS and JOA scores between two groups before operation. Compared with control group, the VAS scores in experimental group at 1 d, and 1 m after operation were decreased statistically, while the JOA scores were increased statistically. Conclusion: Three-dimensional visualization model of lumbar spine and virtual operation planning can directly judge the feasibility of intervertebral foramen endoscopy in the treatment of lumbar disc herniation, improve the efficiency of operation, and further improve postoperative efficacy with pain management.


Neurosurgery ◽  
2004 ◽  
Vol 54 (4) ◽  
pp. 939-942 ◽  
Author(s):  
Enrico Tessitore ◽  
Nicolas de Tribolet

Abstract INTRA- AND EXTRAFORAMINAL disc herniations can be treated via a lateral approach. The far-lateral approach is a muscle-splitting approach that allows surgeons to reach the disc herniation without any facet bone removal. The target of the surgical exposure is the isthmus. Good knowledge of the anatomic features of the intervertebral foramen and intertransverse space is mandatory. The transmuscular approach is discussed. We provide illustrations and a video to emphasize some operative aspects.


2019 ◽  
Vol 12 (2) ◽  
pp. 139-146
Author(s):  
Mladen E. Ovcharov ◽  
Iliya V. Valkov ◽  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev

Summary Lumbar disc herniation (LDH) is the most common pathology in young people, as well as people of active age. Despite sophisticated and new minimally invasive surgical techniques and approaches, reoperations for recurrent lumbar disc herniation (rLDH) could not be avoided. LDH recurrence rates, reported in different studies, range from 5 to 25%. The purpose of this study was to estimate the recurrence rates of LDH after standard discectomy (SD) and microdiscectomy (MD), and compare them to those reported in the literature. Retrospectively, operative reports for the period 2012-2017 were reviewed on LDH surgeries performed at the Neurosurgery Clinic of Dr Georgi Stranski University Hospital in Pleven. Five hundred eighty-nine single-level lumbar discectomies were performed by one neurosurgeon. The diagnoses of recurrent disc herniation were based on the development of new symptoms and magnetic resonance/computed tomography (MRI/CT) images showing compatible lesions in the same lumbar level as the primary lumbar discectomies. The recurrence rate was determined by using chi-square tests and directional measures. SD was the most common procedure (498 patients) followed by MD (91 patients). The cumulative reoperation rate for rLDH was 7.5%. From a total number of reoperations, 26 were males (59.1%) and 18 were females (40.9%). Reoperation rates were 7.6% and 6.6% after SD and MD respectively. The recurrence rate was not significantly higher for SD. Our recurrence rate was 7.5%, which makes it comparable with the rates of 5-25% reported in the literature.


2018 ◽  
Vol 8 (5) ◽  
pp. 14-19
Author(s):  
Tri Truong Van ◽  
Tri Tran Duc Duy ◽  
Khai Vo Le Quang

Introduction: Surgical wound infection in developing coutries is about 3%. Antibiotics prophylaxis may help to reduce the surgical site infection. The objective of this study was to evaluate the efficacy of antibiotics prophylaxis in patients with lumbar disc herniation who were treated with lumbar discectomy at Hue University hospital. Materials and Methods: A prospective study was conducted at Hue University hospital from March 2015 to May 2018 on 54 patients with lumbar disc herniation who were used antibiotics prophylaxis when undergoing discectomy. Results: The infection rate in our study was 0%. Antibiotics prophylaxis reduced the length of hospitalization as well as the medical cost. Conclusion: Antibiotics prophylaxis was effective in preventing surgical site infection despite the fact that the condition of operating rooms did not meet the standard rules. Key words: prophylaxis antibiotics, lumbar disc herniation


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