Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation in Obese Patients: Health-Related Quality of Life Assessment in a 2-Year Follow-Up

Kapetanakis, Stylianos; Gkantsinikoudis, Nikolaos; Chaniotakis, Constantinos; Charitoudis, Georgios; Givissis, Panagiotis

doi:10.1016/j.wneu.2018.02.112

Cited by 30 publications

(26 citation statements)

References 27 publications

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“…Given the respect of muscle and paraspinal tissues, limited intraoperative blood loss, and the short operative time, besides being relevant for all those young patients with sequestered disc fragments, this approach could be potentially suitable in groups of individuals with special requirements: such as patients with obesity, coagulopathies, or for professional athletes seeking an early return to competitions. [34][35][36][37] Over the years the instrumentation for endoscopic spine surgery evolved, and newer models are nowadays available so that beyond the EasyGo system tested in this trial percutaneous interlaminar endoscopic approaches can be performed with other full-endoscopic surgical systems. In the future the choice will be even broader due to the continuous competition between producing companies: for the end-user this clearly represents a good news since competition is usually helpful in bringing down costs of initial acquisition or renting.…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of Percutaneous Interlaminar Endoscopic Lumbar Sequestrectomy: A Modern Strategy to Tackle Medically-Refractory Radiculopathies and Restore Spinal Function

et al. 2019

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Objective: Angled scopes allow 360° visualization, which makes percutaneous endoscopic techniques (percutaneous endoscopic lumbar discectomy, PELD) particularly attractive for sequestrectomies, which entail the removal of extruded lumbar disc fragments that have migrated caudally or cranially between the ligaments, foramina, and neural structures, while preserving the disc. Although many different PELD techniques are currently available, not all of them are suitable for sequestrectomies; furthermore, long-term follow-up data are unfortunately lacking. Methods: A pilot study was conducted on a cohort of 270 patients with lumbar radiculopathy undergoing minimally invasive spine surgery (PELD or microdiscectomy), of whom only 7 were eligible for endoscopic interlaminar sequestrectomy with disc preservation. The patients' baseline conditions and clinical outcomes were measured with the Oswestry Disability Index and a visual analogue scale. Long-term follow-up was conducted using satisfaction questionnaires that were based on the MacNab criteria and administered by medical/nursing personnel not involved in their primary surgical management. Results: EasyGo system was eventually used in 5 PELD cases. No dural tears, infections, or nerve root injuries were recorded in patients undergoing sequestrectomy. Surgical events, including blood loss and overall length of hospital stay, did not differ significantly among the 270 patients. In the group treated with endoscopic sequestrectomy, no recurrences or complications were noted during a follow-up of 3 years, and an excellent degree of satisfaction was reported. Conclusion: We provide OCEBM (Oxford Centre for Evidence-Based Medicine) level 3 evidence that interlaminar endoscopic sequestrectomy is a tailored and well-tolerated surgical option; nonetheless, a cost-effectiveness analysis assessing the interval until return to working activities and long-term benefits is warranted.

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Section: Discussionmentioning

confidence: 99%

A Pilot Study of Percutaneous Interlaminar Endoscopic Lumbar Sequestrectomy: A Modern Strategy to Tackle Medically-Refractory Radiculopathies and Restore Spinal Function

et al. 2019

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“…The utilization of local anesthesia with mild sedation eliminates the potentiality of hazardous general anesthesia-related complications emergence. [8][9][10][22][23][24] Revision surgery for RLDH constitutes a challenge for the spine surgeon. The initial conventional open discectomy/microdiscectomy results in epidural scarring, primarily encountered around dura mater and nerve roots.…”

Section: Discussionmentioning

confidence: 99%

“…Remarkable surgical advantages as preservation of dorsal musculature and spine elements as well as minimization of perioperative morbidity are responsible for its exponential expansion in current years. [8][9][10] To our best knowledge, recruitment of FELD for RLDH after conventional open discectomy/ microdiscectomy has been described few times in the literature. [11][12][13][14][15][16] However, in none of these studies was patients' health-related quality of life (HRQoL) assessed, so that a more multifaceted evaluation of FELD for RL-DH could be accomplished.…”

Section: Introductionmentioning

confidence: 99%

The Role of Full-Endoscopic Lumbar Discectomy in Surgical Treatment of Recurrent Lumbar Disc Herniation: A Health-Related Quality of Life Approach

2019

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Objective: To investigate the utility of full-endoscopic lumbar discectomy (FELD) in surgical treatment of recurrent lumbar disc herniation (RLDH). Methods: Forty-five patients were prospectively studied. All patients were subjected to FELD for RLDH. They were assessed preoperatively and in regular intervals at 6 weeks and 3 months, 6 months, and 12 months postoperatively. Evaluation was conducted with visual analogue scale for leg (VAS-LP) and low back (VAS-BP) pain. Short-Form 36 Health Survey Questionnaire was utilized for health-related quality of life assessment. Results: All studied parameters featured statistically significant amelioration at all follow-up intervals. Maximal improvement was in general at 6 weeks observed, with subsequent lesser improvement until 6 months and stabilization until the end of follow-up. Comparative assessment indicated that VAS-BP displayed quantitatively lower improvement, whereas physical function, bodily pain, and role-emotional parameters demonstrated greater amelioration. Conclusion: FELD is associated with a favorable impact in postoperative daily life of patients with RLDH.

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“…Statistically satisfactory results were observed in both groups for all indices evaluated. 21 As regards the incidence of complications, studies have not reported differences between obese and non-obese patients following endoscopic procedure. Cole et al observed 9.4% cases of iatrogenic durotomy in 22 obese patients.…”

Section: Discussionmentioning

confidence: 99%

Lumbar Endoscopic Discectomy in Obese Patients

et al. 2019

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Objective The aim of this study was to evaluate the clinical and functional results of endoscopic lumbar discectomy in obese patients. Methods We selected 56 patients with lumbar disc hernia refractory to clinical treatment that underwent endoscopic discectomy. Twenty-five patients with a body mass index (BMI) greater than or equal to 30 kg/m 2 were analyzed through the Visual Analogue Scale and functional evaluation using the Oswestry Disability Index questionnaire and compared to 31 patients in the control group (BMI between 18.5 and 24.9 kg/m 2 ). These data were obtained in the preoperative period, in the immediate postoperative period, at 1 month, 3 months, 6 months and one year after surgery. Results The mean BMI in the control group was 22.1 kg/m 2 , and in the obese group, 33.6 kg/m 2 . In both groups there was a statistically significant improvement in clinical and functional analyzes. There was no statistical difference between the groups. Conclusions Lumbar transforaminal endoscopic discectomy has been shown to be a safe, effective and minimally invasive alternative for the treatment of lumbar disc herniation in obese patients. Level of Evidence III; Retrospective and Comparative Study.

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Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation in Obese Patients: Health-Related Quality of Life Assessment in a 2-Year Follow-Up

Cited by 30 publications

References 27 publications

A Pilot Study of Percutaneous Interlaminar Endoscopic Lumbar Sequestrectomy: A Modern Strategy to Tackle Medically-Refractory Radiculopathies and Restore Spinal Function

A Pilot Study of Percutaneous Interlaminar Endoscopic Lumbar Sequestrectomy: A Modern Strategy to Tackle Medically-Refractory Radiculopathies and Restore Spinal Function

The Role of Full-Endoscopic Lumbar Discectomy in Surgical Treatment of Recurrent Lumbar Disc Herniation: A Health-Related Quality of Life Approach

Lumbar Endoscopic Discectomy in Obese Patients

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