Full-Endoscopic Interlaminar Lumbar Discectomy: Retrospective Review of Clinical Results and Complications in 545 International Patients

Wasinpongwanich, Kanthika; Pongpirul, Krit; Lwin, Khin Myat Myat; Kesornsak, Withawin; Kuansongtham, Verapan; Ruetten, Sebastian

doi:10.1016/j.wneu.2019.07.101

Cited by 27 publications

(21 citation statements)

References 16 publications

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“…Notably, some complications, such as incomplete removal of a herniated disc, early recurrence, dysesthesia, fiber bundle injury of partial nerve roots and piriformis syndrome must be differentiated 14 . Special caution should be exercised in cases of incomplete removal and recurrence, as these two complications often necessitate secondary surgery.…”

Section: Discussionmentioning

confidence: 99%

A Postoperative Phenomenon of Percutaneous Endoscopic Lumbar Discectomy: Rebound Pain

Zhang

et al. 2021

Orthopaedic Surgery

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Objective: After percutaneous endoscopic lumbar discectomy (PELD), most patients with lumbar disc herniation (LDH) experience relief from the typical symptoms of low back and leg pain. However, for a small number of patients, these symptoms are relieved immediately after surgery but aggravated soon after, and then relieved after short-term full rest or conservative treatment. The aim of the study was to demonstrate this short-term recurrent phenomenon, termed rebound pain.Methods: A retrospective study was conducted on 144 patients who underwent single-segment PELD from May 2017 to June 2020. Postoperative patients were divided into a rebound pain group and a non-rebound pain group. For the former group, general information, symptom characteristics and visual analogue score (VAS) changes in rebound pain were summarized. For both groups, postoperative efficacy was evaluated by recent VAS of low back and leg pain in the remission stage, the Oswestry disability index (ODI) and the modified MacNab criteria at the last follow-up. Logistic regression analysis was used to identify predictors for rebound pain. Results:The VAS and ODI exhibited significant improvements at the last follow-up of average 15.4 months (P < 0.001). The successful outcomes according to the modified MacNab criteria reached 94.4%. A total of 15 patients (10.4%) experienced rebound pain. The typical feature was pain that usually began within 1 month after surgery and lasted for less than 1 month. The symptoms were mainly leg pain with or without low back pain. The range of pain was equal to or less than that before surgery. The symptoms were relieved after conservative treatment. In logistic regression model, postoperative return-to-work time > 45 days was found as a protective factor for rebound pain (p = 0.031). Conclusion:Although rebound pain with multiple characteristics and a short duration had no significant effect on long-term postoperative efficacy, its high incidence often caused unnecessary concern in both patients and doctors. As a result, careful differentiation of rebound pain from other postoperative complications is needed.

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Section: Discussionmentioning

confidence: 99%

A Postoperative Phenomenon of Percutaneous Endoscopic Lumbar Discectomy: Rebound Pain

Zhang

et al. 2021

Orthopaedic Surgery

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“…Meanwhile, it will also significantly increase the rate of postoperative infection 43) . L4-5 and L5-S1 are the most susceptible levels with lumbar disc herniation, and there are 12.11% of patients with recurrent herniation who have undergone conservative or surgical treatment 44) . The average age of spine patients is widespread older which is one of the predisposing factors for the frustrated operation outcomes 45) .…”

Section: ) Revisionmentioning

confidence: 99%

“…There were no surgery-related complications occurred, and the clinical outcomes improved significantly. Wasinpongwanich et al reported a series of 545 international patient retrospective reviews of IELD postoperative outcomes 44) . The recurrence rate of all patients after being treated with IELD surgery .…”

Section: ) Revisionmentioning

confidence: 99%

A Review of Full-endoscopic Interlaminar Discectomy for Lumbar Disc Disease: A Historical and Technical Overview

Liu

Kim

Chen³

et al. 2021

J Minim Invasive Spine Surg Tech

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Lumbar disc disease is an age or trauma-related disc injury with the clinical symptoms such as lower back pain or sciatica. Surgical treatment is the reliable and effective solution only if the symptoms grow progressively worse and conservative treatments fail. The purpose of spinal surgery is to remove the real pain generator and maintain physiological spinal alignment. Traditionally, patients after discectomy tend to experience the risk of postoperative intervertebral disc degeneration with intractable low back pain. Therefore, the minimally invasive techniques have rapidly developed in the past decades and brought revolutionary progress on techniques modification. Herein, we report the historical overview of the interlaminar fullendoscopic lumbar discectomy and technical evolution based on the review of literature.

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“…According to statistics from Parker et al [4] , the proportion of patients reporting short-term (6-24 months) and long-term (> 24 months) recurrent LBP ranged from 3-34% and 5-36%, respectively. Even for minimally invasive operations, approximately 8.4-25% of patients receiving lumbar percutaneous transforaminal endoscopic discectomy (PTED) still have residual LBP after surgery [5] [6] . In addition, postoperative LBP can be improved by rehabilitation treatment [7] [8] , especially spinopelvic rehabilitation [9] .…”

Section: Introductionmentioning

confidence: 99%

Correlation Among Residual Pain, Spinopelvic Parameters and Area of Fat Infiltration in Lumbar Multifidus Muscles in Patients after Lumbar Surgery: A Cross-Sectional Study.

Zhong¹,

Ding²,

Fu³

et al. 2021

Preprint

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Background: Numerous studies have reported that pelvic functional training is beneficial for improving low back pain (LBP) in patients with lumbar disc herniation (LDH) after lumbar surgery and that fat infiltration of the lumbar multifidus muscles (LMMs) is one of the most important reasons for residual LBP after surgery. However, little is known about the exact relationship among residual LBP, spinopelvic parameters and the area of fat infiltration in LMM after lumbar surgery. This study aimed to confirm the relationship among residual LBP, spinopelvic parameters and the area of fat infiltration in LMM and to investigate why pelvic functional training can relieve pain symptoms in patients with LDH after lumbar surgery.Methods: One hundred forty-three patients with LDH were involved in this study. Clinical data were collected from a system of digital medical records, including age, gender, course, and weight. On the MRI images, the cross-sectional areas (CSAs) of bilateral fat infiltration in the LMM were measured using a picture archiving and communication system (PACS). On the X-ray, sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI) were also measured by PACS. Pearson correlation analysis was applied to analyse the differences between CSA of fat infiltration in LMM and spinopelvic parameters, and ROC curves were used to reflect the degree of fat infiltration in LMM with spinopelvic parameters.Results: One hundred and twenty-five patients met the inclusion criteria. SS and PI were positively correlated with CSA of fat infiltration in LMM at L3-4 and L4-5 (p < 0.01). At L4-5, SS and PI demonstrated significant positive correlation with the CSA of fat infiltration in the LMM (0.5 < | r | < 0.8). PI also exhibited a significant positive correlation with VAS (0.5 < | r | < 0.8), but SS had a low correlation with VAS (0.3 < | r | < 0.5). At L4-5, only the PI had a significant ROC curve (AUC = 0.836) with a cut-off point score of 0.556 and sensitivity and specificity values of 62.8% and 87.4%, respectively. However, at L3-4 and L5-S1, the AUCs of the ROC curves were all < 0.7 for SS, PT and PI. Conclusions: The wider pelvic anterior tilt, the more severe fat the infiltration in LMM. Residual LBP can be relieved by spinopelvic correction training potentially due to the improvement of fat infiltration in LMM.

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Full-Endoscopic Interlaminar Lumbar Discectomy: Retrospective Review of Clinical Results and Complications in 545 International Patients

Cited by 27 publications

References 16 publications

A Postoperative Phenomenon of Percutaneous Endoscopic Lumbar Discectomy: Rebound Pain

A Postoperative Phenomenon of Percutaneous Endoscopic Lumbar Discectomy: Rebound Pain

A Review of Full-endoscopic Interlaminar Discectomy for Lumbar Disc Disease: A Historical and Technical Overview

Correlation Among Residual Pain, Spinopelvic Parameters and Area of Fat Infiltration in Lumbar Multifidus Muscles in Patients after Lumbar Surgery: A Cross-Sectional Study.

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Full-Endoscopic Interlaminar Lumbar Discectomy: Retrospective Review of Clinical Results and Complications in 545 International Patients

Cited by 27 publications

References 16 publications

A Postoperative Phenomenon of Percutaneous Endoscopic Lumbar Discectomy: Rebound Pain

A Postoperative Phenomenon of Percutaneous Endoscopic Lumbar Discectomy: Rebound Pain

A Review of Full-endoscopic Interlaminar Discectomy for Lumbar Disc Disease: A Historical and Technical Overview

Correlation Among Residual Pain, Spinopelvic&nbsp;Parameters and Area of Fat Infiltration in Lumbar Multifidus Muscles in Patients after Lumbar Surgery: A Cross-Sectional Study.

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Correlation Among Residual Pain, Spinopelvic Parameters and Area of Fat Infiltration in Lumbar Multifidus Muscles in Patients after Lumbar Surgery: A Cross-Sectional Study.