Comparison of percutaneous transforaminal endoscopic lumbar discectomy through unilateral versus bilateral approach for L3/4 or L4/5 lumbar disc herniation with bilateral symptoms: technical notes and a prospective randomized study

Li, Kang; Gao, Kai; Zhang, Tao; Lv, Chaoliang

doi:10.1007/s00586-019-06210-y

Cited by 8 publications

(10 citation statements)

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“…Full text of the remaining 52 articles was carefully evaluated. 9 studies that met the inclusion and exclusion criteria were eventually included in this meta-analysis [22][23][24][25][26][27][28][29][30]. A total of 2505 patients were included in this analysis, and the basic characteristics of the included study are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Effects of Enhanced Recovery Rehabilitation Surgery Concepts on the Surgical Process, Postoperative Pain, Complications, and Prognosis of Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Wu¹,

Wang²,

Zhao³

2022

Computational and Mathematical Methods in Medicine

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Objective. The purpose of this study was to investigate the effect of lumbar disc herniation (LDH) disease degree on lumbar discectomy and to explore the relationship between the degree of intervertebral disc disease and postoperative pain score changes. Methods. We conducted a comprehensive search in China National Knowledge Infrastructure (CNKI), Wanfang Data, PubMed, MEDLINE, Embase, Cochrane database, and other databases, obtained all relevant studies as of April 2017, and then followed strict inclusion and exclusion criteria. Standard screening was performed on the retrieved literature. We extract and analyze key data using Review Manager 5.3 software. Pooled effects were calculated by mean difference or odds ratio and 95% confidence interval analysis, depending on data attributes. Results. Various databases were searched for the results of papers from lumbar discectomy since April 2017 to April 2022. Nine papers from 2502 patients were selected. The average overall follow-up was 52 weeks. There were statistically significant reductions in postoperative pain scores and degree of disc disease. There was a significant correlation between the reduction in pain score after discectomy and the degree of disc disease ( r = 0.73 , 95 % CI = 0.01 -1.20, p = 0.005 ). Conclusions. Decreased disc disease grade is one of the reasons for the lower back pain score after discectomy. Furthermore, region-dependent economic factors must be considered before developing a treatment strategy. Larger, well-defined randomized controlled trials are needed to further confirm these results.

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Section: Resultsmentioning

confidence: 99%

Effects of Enhanced Recovery Rehabilitation Surgery Concepts on the Surgical Process, Postoperative Pain, Complications, and Prognosis of Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Wu¹,

Wang²,

Zhao³

2022

Computational and Mathematical Methods in Medicine

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“…Li et al described the technical details of unilateral percutaneous transforaminal endoscopic lumbar discectomy (PTELD) and compared unilateral versus bilateral PTELD for L3/4 or L4/5 lumbar disc herniation with bilateral symptoms in a randomized clinical trial [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…We used G*Power software to determine the sample size. The sample size calculation was conducted based on a study conducted by Li et al [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Evaluating Predictive Value of Preoperative Clinical and Imaging Findings on the Short-Term Outcome of Surgery in Patients Undergoing Lower Lumbar Discectomy

Tabibkhooei¹,

Ziaei²,

Azar³

et al. 2021

Cureus

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Objective: The most common indications for spinal surgery are low back pain and associated disabilities caused by disc herniation. Given the high prevalence of low back pain, the critical nature of pain assessment in these patients, and knowledge about the influencing and predisposing factors, we sought to evaluate the clinical and radiologic findings associated with pain relief and postoperative recovery in patients who underwent bilateral lumbar discectomy.Methods: From March 2016 to October 2020, a prospective cohort study was conducted. This study included adult patients with symptomatic disc herniation in the L4-L5 and L5-S1 segments who were candidates for bilateral discectomy. Before and after surgery, patients were evaluated for lumbar and radicular pain and the Oswestry Disability Index (ODI) score and at the four, 12, and 24-week follow-up. Meanwhile, a variety of demographic, clinical, and radiologic factors was collected and statistically analyzed.Results: This study enrolled 30 patients. The average age of the patients was 41.2 years, with 22 males and eight females. Twelve of these patients had disc involvement in the L4-L5 region, while 18 had disc involvement in the L5-S1 region. Statistical analysis revealed that radicular pain and disability associated with low back pain significantly decreased following surgery (P=0.001). However, there was no significant reduction in back pain (P>0.05). Patients with a higher body mass index (BMI) and neurological claudication had a lower reduction in radicular pain (P<0.05). Moreover, a higher BMI and the presence of instability pain are associated with an increased likelihood of postoperative lumbar pain relief (P<0.01). Among the radiological variables, increased disc height was associated with a more rapid recovery from low back disability (P=0.003). Furthermore, a larger diameter of paraspinal muscles at the level of the herniated disc was associated with a more rapid improvement of lower back pain (P=0.021). Conclusion:The use of discectomy in patients with lumbar disc herniation significantly alleviates postoperative and follow-up radicular pain. Age, BMI, neurological claudication, instability pain, and paraspinal muscle diameter played a role in postoperative pain relief. Increased disc height was associated with a more rapid decline in the ODI score. Future studies with larger sample sizes are recommended.

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“…In addition, lumbar discectomy can enlarge local tissue through the monitor, improve the accuracy of the operation, and reduce the degree of damage to the paravertebral muscles. Postoperative pain is less severe, recovery is faster, lumbar spine and back function training can be started early, wound infections are reduced, as well as lumbar instability and other complications, and hospital stay is shortened[ 17 , 18 ]. However, all operations under MED are performed in narrow passages, which will reduce the scope of the operation and increase the difficulty of the operation[ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of microendoscopic discectomy and open discectomy for single-segment lumbar disc herniation

Pang¹,

Tan²,

Chen³

et al. 2020

WJCC

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BACKGROUND Lumbar disc herniation is a common disease. Endoscopic treatment may have more advantages than traditional surgery. AIM To compare the clinical efficacy and safety of microendoscopic discectomy (MED) and open discectomy with lamina nucleus enucleation in the treatment of single-segment lumbar intervertebral disc herniation. METHODS Ninety-six patients who were operated at our hospital were selected for this study. Patients with single-segment lumbar disc herniation were admitted to the hospital from March 2018 to March 2019 and were randomly divided into the observation group and the control group with 48 cases in each group. The former group underwent lumbar discectomy and the latter underwent laparotomy and nucleus pulpectomy. Surgical effects were compared between the two groups. RESULTS In terms of surgical indicators, the observation group had a longer operation time, shorter postoperative bedtime and hospital stay, less intraoperative blood loss, and smaller incision length than the control group ( P < 0.05). The excellent recovery rate did not differ significantly between the observation group (93.75%) and the control group (91.67%). Visual analogue scale pain scores were significantly lower in the observation group than in the control group at 1 d, 3 d, 1 mo, and 6 mo after surgery ( P < 0.05). The incidence of complications was significantly lower in the observation group than in the control group (6.25% vs 22.92%, P < 0.05). CONCLUSION Both MED and open discectomy can effectively improve single-segment lumbar disc herniation, but MED is associated with less trauma, less bleeding, and a lower incidence of complications.

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Comparison of percutaneous transforaminal endoscopic lumbar discectomy through unilateral versus bilateral approach for L3/4 or L4/5 lumbar disc herniation with bilateral symptoms: technical notes and a prospective randomized study

Cited by 8 publications

References 11 publications

Effects of Enhanced Recovery Rehabilitation Surgery Concepts on the Surgical Process, Postoperative Pain, Complications, and Prognosis of Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Effects of Enhanced Recovery Rehabilitation Surgery Concepts on the Surgical Process, Postoperative Pain, Complications, and Prognosis of Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Evaluating Predictive Value of Preoperative Clinical and Imaging Findings on the Short-Term Outcome of Surgery in Patients Undergoing Lower Lumbar Discectomy

Comparison of microendoscopic discectomy and open discectomy for single-segment lumbar disc herniation

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