Comparison of tissue damages caused by endoscopic lumbar discectomy and traditional lumbar discectomy: A randomised controlled trial

Pan, Lei; Zhang, Peifang; Yin, Qudong

doi:10.1016/j.ijsu.2014.02.015

Cited by 85 publications

(65 citation statements)

References 22 publications

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“…Endoscopic procedures for treatment of spinal diseases firstly came out in 1992 and have been widely applied in clinical practice for lumbar spine diseases, as the rapid development of endoscopic technology. Recent studies have reported that they could achieve equal curative effect with less trauma and shorter hospital stay compared to traditional surgeries [3][4][5][6]. Our results showed that 71 (82.6%) out of 86 cases achieved good or excellent surgical outcomes which further confirmed that PELD was an effective and reliable method for the treatment of LDH.…”

supporting

confidence: 78%

“…Patients with lumbar disc herniation (LDH) usually present with symptoms like pain, numbness, and weakness, which have a negative influence on their social functions [1,2]. Percutaneous endoscopic lumbar discectomy (PELD) first appeared in 1992 [3] and has been widely used in clinical practice for lumbar spine diseases due to less invasiveness and faster recovery compared with traditional surgery [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Numbness and Weakness Recovered at a Less Extent in Patients with Lumbar Disc Herniation after Percutaneous Endoscopic Lumbar Discectomy

Wang

Gao

Zou

2019

Pain Research and Management

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Background. Patients with lumbar disc herniation (LDH) may present with motor disorders and various sensory disorders, among which pain and numbness are the most common ones. Percutaneous endoscopic lumbar discectomy (PELD) is reported to be both safe and effective. However, most of the previous studies focused on the recovery of pain, and the relief extent of numbness and weakness has rarely been reported. The Sciatica Bothersomeness Index (SBI) is a self-assessment tool for LDH patients. It has demonstrated acceptable reliability, construct validity, and responsiveness. Objectives. Our aim was to explore the curative effect of percutaneous endoscopic lumbar discectomy and to compare the various extent of relief among pain, numbness, and weakness. Methods. The medical records of patients admitted for LDH from September 2016 to December 2018 were collected, and the patients were followed up for 3 months to evaluate the relief of their clinical symptoms. Preoperative and postoperative total scores and subitem scores of SBI were compared to evaluate the relief of pain, numbness, and weakness. Surgical outcomes of PELD were evaluated by the Nakai score, and patients were divided into two groups accordingly, which were the relief group (excellent and good in the Nakai score) and the less relief group (fair and poor in the Nakai score). Risk factors for PELD outcomes and preoperative presence of numbness and/or weakness were analyzed by the logistic model, and p value less than 0.05 was considered significant. Results. A total of 86 patients met the inclusion criteria and acquired 3 months follow-up. Relief extent of pain, numbness, and weakness, was 82%, 41%, and 21%, respectively. There were 71 cases in the relief group and 15 cases in the less relief group. Results of the logistic regression analysis showed that the preoperative pain score of SBI (p=0.002; OR: 1.647 (1.199–2.261)) was a relatively independent risk factor for PELD outcomes, and multiplicativity of duration of preoperative symptoms and imaging grade [p=0.004; OR: 1.015 (1.005–1.026)] was a relatively independent risk factor for preoperative presence of numbness and/or weakness. Conclusions. PELD had a good curative effect in the treatment of LDH. Patients of LDH recovered best from pain, followed by numbness and weakness after PELD. Higher level of patients self-reported preoperative pain indicated a better surgical outcome for LDH patients, and preoperative long duration of symptoms together with a severe compression of nerve root significantly increased the risk of presenting numbness and/or weakness.

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supporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Numbness and Weakness Recovered at a Less Extent in Patients with Lumbar Disc Herniation after Percutaneous Endoscopic Lumbar Discectomy

Wang

Gao

Zou

2019

Pain Research and Management

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“…And Lowell et al 19 reported that three patients undergoing open discectomy got infected after administration of perioperative steroids. Infections are rarely seen owing to the measures of continuous irrigation, prophylactic antibiotics, minimal tissue damage 20 and short surgery time. Other adverse effect such as osteoporosis is rare.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of epidural and intravenous steroids after percutaneous endoscopic lumbar discectomy for large lumbar disc herniation

Yang

Zeng

et al. 2017

Chinese Journal of Traumatology

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ObjectiveTo assess the early curative effect of epidural or intravenous administration of steroids during a percutaneous endoscopic lumbar discectomy (PELD).Methods28 consecutive patients who underwent PELD due to large lumbar disc herniation between November 2014 and January 2016 were followed up for 6 months. These patients were divided into two groups according to the treatment they received after PELD. 14 patients (Group A) were treated by PELD and epidural steroids, while the other 14 patients (Group B) were treated by PELD and intravenous steroids. We evaluated the effectiveness by the preoperative and postoperative visual analogue scale (VAS) scores for back and leg pain, and the postoperative Oswestry disability index (ODI) at 3 weeks after surgery via the clinical charts and telephone interview. Postoperative hospital stay and time return to work were investigated as well.ResultsThere is a significant decrease in VAS (back, leg), ODI, and time return to work (p < 0.05). For VAS (back), Group A showed a significant decrease compared with Group B at 1 day and 1 week after surgery (p = 0.011, p = 0.017). As for VAS (leg), Group A showed a significant decrease compared with Group B at 1 day, 1 week, 3 weeks, and 3 months follow-up examinations (p = 0.002, p = 0.006, p < 0.001, p < 0.001). For ODI, Group A showed a notable decrease compared with Group B (p < 0.001). The postoperative hospital stay in two groups was not statistically different (p = 0.636). But the time return to work in Group A was significantly shorter than that in Group B (p = 0.023).ConclusionPatients who underwent PELD with epidural steroid administration for large lumbar disc herniation showed favorable curative effect compared with those who underwent PELD with intravenous steroid administration.

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“…При этом результаты сравнительного анализа марке-ров воспаления и маркеров болевого синдрома, получен-ные L. Pan и соавт. [21], подтверждают значительные пре-имущества перкутанного эндоскопического метода по сравнению с микрохирургическим методом. C. Schizas [22] среди недостатков эндоскопических методов отмечает низкое качество изображения, которое, в сравнении с микроскопическим, не передает объема и глубины.…”

Section: эффективность метода эндоскопической дискэктомииunclassified

Modern treatments for degenerative disc diseases of the lumbosacral spine. A literature review

et al. 2016

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ОбзОры История применения эндоскопической техники удаления грыж межпозвонковых дисков поясничного отдела позвоночникаПервое сообщение о возможности эндоскопии в спи-нальной хирургии сделано M. Burman [1], использовав-шим эндоскоп диаметром 9,5 мм для осмотра конского хвоста на трупах. Автор пришел к выводу, что техническое несовершенство оборудования не позволяет использовать эндоскопию в клинике, но прогнозировал возможность применения данного метода с целью уточнения диагноза.L. Pool [2] использовал модифицированный отоскоп с освещением для обследования корешков при грыже диска и при некоторых других видах патологии позвоночного канала. Впервые эндоскопическую биопсию ткани меж-

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Comparison of tissue damages caused by endoscopic lumbar discectomy and traditional lumbar discectomy: A randomised controlled trial

Abstract: The PELD had less damage to human tissues than the traditional OD. PELD has a clear promotional value in clinical.

Cited by 85 publications

References 22 publications

Numbness and Weakness Recovered at a Less Extent in Patients with Lumbar Disc Herniation after Percutaneous Endoscopic Lumbar Discectomy

Numbness and Weakness Recovered at a Less Extent in Patients with Lumbar Disc Herniation after Percutaneous Endoscopic Lumbar Discectomy

A retrospective study of epidural and intravenous steroids after percutaneous endoscopic lumbar discectomy for large lumbar disc herniation

Modern treatments for degenerative disc diseases of the lumbosacral spine. A literature review

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