Percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decompression for lateral recess stenosis through transforaminal approach: Technique notes and 2 years follow-up

Li, Zhenzhou; Hou, Shuxun; Shang, Wei-lin; Cao, Zheng; Zhao, Huanying

doi:10.1016/j.clineuro.2016.02.008

Cited by 104 publications

(98 citation statements)

References 10 publications

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“…Five-year data combining PELD with percutaneous lumbar foraminoplasty (PLF) demonstrates promising results with improvement in ODI and modified MacNab criteria. When combined with PLF in 134 patients, Li et al demonstrated a 93% 5-year patient satisfaction rate [83]. Moreover, when evaluating the outcomes of full-endoscopic interlaminar discectomy (FELD), Tu et al also demonstrated significant 5-year improvement in VAS, ODI, modified MacNab criteria, and 90% 5-year good or excellent patient satisfaction [84•].…”

Section: Long-term Follow-upmentioning

confidence: 99%

Lumbar Disc Herniation

Amin

Andrade

Neuman³

2017

Curr Rev Musculoskelet Med

207

202

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Purpose of Review Substantial advancements have been made in the cause, diagnosis, imaging, and treatment options available for patients with lumbar disc herniation (LDH). We examined the current evidence and highlight the concepts on the frontline of discovery in LDH. Recent Findings There are a myriad of novel etiologies of LDH detailed in recent literature including inflammatory factors and infectious microbes. In the clinical setting, recent data focuses on improvements in computer tomography as a diagnostic tool and non-traditional injection options including tumor necrosis alpha inhibitors and platelet-rich plasma. Operative treatment outcomes have focused on minimally invasive endoscopic approaches and demonstrated robust 5-year post-operative outcomes. Summary Advances in the molecular etiology of LDH will continue to drive novel treatment options. The role of endoscopic treatment for LDH will continue to evolve. Further research into10-year outcomes will be necessary as this surgical approach continues to gain widespread popularity.

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Section: Long-term Follow-upmentioning

confidence: 99%

Lumbar Disc Herniation

Amin

Andrade

Neuman³

2017

Curr Rev Musculoskelet Med

207

202

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“…2). 5, 6, 7 After sufficient decompression and epidural pulsating (Fig. 3), a single dose of intravenous or epidural betamethasone was administered: 1 ml of betamethasone was administered via epidural injection to each patient in Group A, while 1 ml of intravenous betamethasone was administered to each patient in Group B.…”

Section: Methodsmentioning

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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“…[13,14] Sometimes partial facetectomy and outside-in technique is required for LDH combined with foraminal stenosis to prevent ENR injury. [15][16][17][18][19] From our experience, these cases represented less than one third of the total cases and all successfully completed PLPED. The posterolateral approach is able to remove the migrated foraminal LDH except for the high grade upward migration at L5/S1 affected by iliac crest.…”

Section: Discussionmentioning

confidence: 99%

Posterolateral percutaneous endoscopic discectomy with free-running electromyography monitoring under general anesthesia

Kitahama¹,

Matsui²,

Minami³

et al. 2017

MIS

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Aim: Posterolateral percutaneous endoscopic discectomy (PLPED) is commonly performed under local anesthesia, but patients and surgeons are concerned about intraoperative uncontrolled pain. The purpose of this study was to evaluate the safety of the PLPED under general anesthesia with free-running electromyography (EMG) monitoring. Methods: The clinical outcomes of consecutive 48 cases of lumbar disc herniation (LDH) were evaluated by numeric rating scale (NRS) score and MacNab's criteria. Hospital stay and time to ambulation and return to work were also assessed. Results: NRS score for the affected leg significantly improved from 6.4 to 0.9 immediately after the operation. MacNab's criteria were 91.5% for a follow-up period of 13.5 months. Although no serious complication occurred, 3 patients (6.3%) had transient paresis that completely disappeared by 3 months. No recurrences were observed during the follow-up period. Conclusion: PLPED combined with EMG monitoring under general anesthesia is a safe and efficacious procedure for the treatment of LDH. Key words:Percutaneous endoscopic lumbar discectomy, electromyography, lumbar disc herniation, posterolateral approach, numeric rating scale, MacNab's criteria ABSTRACTArticle history:

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Percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decompression for lateral recess stenosis through transforaminal approach: Technique notes and 2 years follow-up

Cited by 104 publications

References 10 publications

Lumbar Disc Herniation

Lumbar Disc Herniation

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

Posterolateral percutaneous endoscopic discectomy with free-running electromyography monitoring under general anesthesia

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