Implementation of Percutaneous Transforaminal Endoscopic Discectomy in Competitive Elite Athletes With Lumbar Disc Herniation: Original Study and Review of the Literature

Kapetanakis, Stylianos; Gkantsinikoudis, Nikolaos; Charitoudis, Georgios

doi:10.1177/03635465211032612

Cited by 8 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 The L4/5 and L5/S1 intervertebral discs are the primary lesion sites in LDH. 5 Anatomical research indicates that L4/5 intervertebral disc herniation is primarily treated with PETD, whereas L5/S1 herniation is more commonly addressed with PEID. 6 Research has established that the L4/5 interlaminar space is situated below the L4/5 intervertebral disc level.…”

Section: Introductionmentioning

confidence: 99%

Modified Percutaneous Endoscopic Interlaminar Discectomy through the Near‐spinous Process Approach for L4/5 Disc Herniation: A Retrospective Clinical Study

Xu,

Yuan,

et al. 2024

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveCompared with traditional open surgery, percutaneous endoscopic lumbar discectomy (PELD) has the advantages of less trauma, faster recovery, and less postoperative pain, so it has been widely used in the field of spinal surgery. However, it still has the defect of intraoperative fluoroscopy occurrences, complications, and even the risk of damage to the spinal cord and nerve. This study aims to compare the clinical efficacy of modified percutaneous endoscopic interlaminar discectomy (MPEID) with percutaneous endoscopic transforaminal discectomy (PETD) in treating L4/5 lumbar disc herniation (LDH) and to evaluate the effectiveness and safety of MPEID.MethodsThirty‐four L4/5 LDH patients treated at the Second Affiliated Hospital of Nanchang University from June 2020 to June 2021 were studied retrospectively. Seventeen underwent MPEID and seventeen PETD. Variables analyzed included demographics, operative duration, intraoperative fluoroscopy occurrences, and surgical outcomes. Effectiveness was evaluated using the visual analogue scale (VAS), Oswestry disability index (ODI), and modified MacNab criteria. Lumbar Magnetic Resonance Imaging (MRI) was used to assess radiological outcomes. A paired t‐test was performed to compare intragroup pre‐ and postoperative clinical data, VAS, and ODI scores.ResultsThe average operative time in PETD group was 91.65 ± 14.04 min, and the average operative time in MPEID group was 65.41 ± 12.61 min (p < 0.001). In PETD group, the fluoroscopy occurrences averaged 9.71 ± 1.05 times, with fluoroscopy occurrences averaging 6.47 ± 1.00 times (p < 0.001) in MPEID group. At 12 months follow‐up, the clinical effect showed significant improvement in both two groups. The MPEID group showed a decrease in average VAS‐back score from 5.41 ± 2.18 to 1.76 ± 1.09 (p < 0.001) and VAS‐leg score from 6.53 ± 1.66 to 0.82 ± 0.64 (p < 0.001). The ODI scores decreased from 51.35 ± 10.65 to 11.71 ± 2.91 (p < 0.001). In the PETD group, the VAS‐back score decreased from 4.94 ± 1.98 to 2.06 ± 1.25 (p < 0.001), VAS‐leg score from 7.12 ± 1.73 to 1.12 ± 0.60 (p < 0.001), and ODI scores from 48.00 ± 11.62 to 12.24 ± 2.56 (p < 0.001). According to the modified MacNab criteria, MPEID had 15 excellent and two good results; PETD had 12 excellent and 5 good (p = 0.23). No nerve root injuries, dural tears, or significant complications were reported.ConclusionMPEID and PETD effectively treat L4/5 LDH, with MPEID showing shorter operative times and fewer fluoroscopies. Furthermore, the MPEID group can provide excellent clinical efficacy as the PETD group in the short term.

show abstract

Section: Introductionmentioning

confidence: 99%

Modified Percutaneous Endoscopic Interlaminar Discectomy through the Near‐spinous Process Approach for L4/5 Disc Herniation: A Retrospective Clinical Study

Xu,

Yuan,

et al. 2024

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…After nerve root stimulation is eliminated, scoliosis can be corrected spontaneously [ 4 , 8 ]. In recent years, PELD has been widely used and recognized in the treatment of lumbar disc herniation [ 9 , 10 ]. Compared with traditional surgical methods, PELD has the advantages of high safety, less trauma, less bleeding, rapid postoperative recovery, little impact on nerve and spinal canal structure, and fewer postoperative complications [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous endoscopic lumbar discectomy for single and double segment lumbar disc herniation with sciatic scoliosis in adults: a retrospective study

Yang,

Luan,

Ren

et al. 2024

BMC Surg

View full text Add to dashboard Cite

Objective Sciatic scoliosis can be seen in patients with lumbar disc herniation. Percutaneous endoscopic lumbar discectomy (PELD) is a common surgical method for the treatment of lumbar disc herniation. The difference between single-segment lumbar disc herniation and double-segment lumbar disc herniation with Sciatic Scoliosis in adults after PELD needs further study. The aim of this study was to compare the imaging features of single-segment and double-segment lumbar disc herniation with Sciatic Scoliosis in adults and to further explore the clinical outcomes of functional improvement and scoliosis imaging parameters of the two groups after PELD. Methods Adult patients with lumbar disc herniation with sciatic scoliosis who received PELD from January 2019 to June 2022 were analyzed retrospectively. According to the number of operative segments, the patients were divided into a single-segment group and a double-segment group. Perioperative parameters were observed and compared between the two groups. The Visual Analogue Scale (VAS) score, Oswestry dysfunction index (ODI), Japanese Orthopaedic Association scores (JOA) and imaging parameters of the two groups were recorded and compared before the operation and during the follow-up. Results A total of 53 patients with single segments and 21 patients with double segments were included in this study. During the follow-up, the VAS score, ODI index and JOA score of the two groups were significantly improved as compared with those before the operation(P < 0. 05). Ninety-two point five percent of single-segment patients and 90.5% of double segment patients returned to normal scoliosis within 12 months after the operation. The operation time, number of intraoperative fluoroscopy times and the amount of intraoperative blood loss in single-segment patients were better than those in double-segment group(P < 0. 05). At the last follow-up, the AVT, CBD and SVA in the double-segment group were 5.2 ± 2.3, 5.1 ± 1.0 and 12.2 ± 3.0 mm, respectively, which were higher than those in the single-segment group (1.9 ± 0.4, 1.1 ± 1.6 and 3.9 ± 2.1 mm) (P < 0. 05). Conclusion PELD is an effective treatment for single-segment and double-segment lumbar disc herniation with Sciatic scoliosis. Double-segment patients can enjoy similar clinical efficacy to single-segment patients, avoiding complications caused by decompression, fusion, and internal fixation. Scoliosis was corrected spontaneously within 12 months after operation, and the sagittal curve was significantly improved in both groups. The improvement of coronal and sagittal balance in double -segment patients may take longer.

show abstract

“…Minimally invasive spine surgery for treating LDDs is gradually being accepted, and spinal endoscopic surgery is one of the most minimally invasive techniques (13)(14)(15). In 2017, we first introduced our PTES (percutaneous transforaminal endoscopic surgery) technique (16) under local anesthesia with reduced steps, simple orientation, and easy puncture, which can significantly decrease the fluoroscopy projection time and shorten the operation time (17).…”

Section: Introductionmentioning

confidence: 99%

How to predict the culprit segment in percutaneous transforaminal endoscopic surgery under local anesthesia for surgical treatment of lumbar degenerative diseases? Radiologic images or clinical symptoms

Zhou

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

ObjectivePercutaneous transforaminal endoscopic surgery (PTES) is a novel, minimally invasive technique used to treat lumbar degenerative diseases (LDDs). PTES under local anesthesia was performed to treat the culprit segment of LDDs predicted by radiologic images or clinical symptoms, and the efficacy, security, and feasibility were evaluated.MethodsEighty-seven cases of LDDs with nerve root symptoms, which were not consistent with lumbar degenerative levels and degrees on MRI and CT, were treated with PTES under local anesthesia in a day surgery ward from January 2015 to December 2019. Forty-two patients, whose culprit segments were predicted by radiologic images, were included in group A. The other 45 patients, whose culprit segments were predicted by clinical symptoms, were included in group B. Leg pain VAS and ODI scores before and after PTES were recorded. The outcome was defined according to the MacNab grade at the 2-year follow-up. Postoperative complications were recorded.ResultsIn group A, 2 patients underwent PTES for one segment, 37 patients underwent PTES for two segments, and 3 patients underwent PTES for three segments. One of the one-segment PTES patients had no relief from symptoms and underwent another PTES for other culprit segments 3 months after surgery. In group B, 44 of 45 patients were treated using PTES for one segment and 1 patient was treated for two segments. Group B showed significantly less operative duration, less blood loss, and less fluoroscopy frequency than group A (p < 0.001). The leg pain VAS score and the ODI score significantly decreased after the operation in both groups (p < 0.001), and the excellent and good rates were 97.6% (41/42) in group A and 100% (45/45) in group B at the 2-year follow-up. The leg pain VAS score of group B was significantly lower than that of group A immediately and 1 week, 1 month, 2 months, and 3 months after surgery (p < 0.001). There was no statistical difference in ODI scores and the excellent and good rates between the two groups. No complications, such as wound infection or permanent nerve injury, were observed.ConclusionIt is much more accurate to predict the culprit segment according to clinical symptoms than radiologic images in PTES under local anesthesia for surgical treatment of LDDs.

show abstract

Implementation of Percutaneous Transforaminal Endoscopic Discectomy in Competitive Elite Athletes With Lumbar Disc Herniation: Original Study and Review of the Literature

Cited by 8 publications

References 25 publications

Modified Percutaneous Endoscopic Interlaminar Discectomy through the Near‐spinous Process Approach for L4/5 Disc Herniation: A Retrospective Clinical Study

Modified Percutaneous Endoscopic Interlaminar Discectomy through the Near‐spinous Process Approach for L4/5 Disc Herniation: A Retrospective Clinical Study

Percutaneous endoscopic lumbar discectomy for single and double segment lumbar disc herniation with sciatic scoliosis in adults: a retrospective study

How to predict the culprit segment in percutaneous transforaminal endoscopic surgery under local anesthesia for surgical treatment of lumbar degenerative diseases? Radiologic images or clinical symptoms

Contact Info

Product

Resources

About