Percutaneous Transforaminal Endoscopic Discectomy versus Micro-Endoscopic Discectomy for Lumbar Disc Herniation

Peng, Yu; Hua, Qiang; Zhou, Jianwei; Huang, Peng

doi:10.12659/msm.913326

Cited by 19 publications

(13 citation statements)

References 35 publications

(66 reference statements)

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“…Although Xu et al performed a similar meta-analysis (nine studies: 468 patients in the FED group and 516 patients in the MED group), no differences in leg pain were found, although lower back pain in the FED group was lesser than that in the MED group 24 months after surgery [ 20 ]. The efficacy of FED for treating low back pain was also reported in another meta-analysis by Yu et al [ 21 ]. Xu et al also reported that there were no significant differences in complication, recurrence, or reoperation rates between FED and MED.…”

Section: Discussionsupporting

confidence: 52%

Comparative Study between Full-Endoscopic Discectomy and Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

et al. 2020

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Background and objectives: Lumbar disc herniation (LDH) is a common disease in the meridian of life. Although surgical discectomy is commonly used to treat LDH, there are several different strategies. We compared the outcomes of uniportal full-endoscopic discectomy (FED) with those of microendoscopic discectomy (MED) in treating LDH. Materials and Methods: FED was performed using a 4.1-mm working channel endoscope, and MED was performed using a 16-mm diameter tubular retractor and endoscope. Data of patients with LDH treated with FED (n = 39) or MED (n = 27) by the single surgeon were retrospectively reviewed. Patient background information and operative data were collected. Pre- and postoperative low back and leg pain were evaluated using the numerical rating scale (NRS) score. Pre- and postoperative disc height index (DHI) values were calculated from plain radiographs, and the disc height loss was evaluated using the ratio (DHI ratio); Results: The median (interquartile range (IQR) Q25–75) operation times for FED and MED were 42 (33–61) and 43 (33–50) minutes, respectively. The median (IQR Q25–75) pre- and postoperative NRS scores for low back pain were 5 (2–7) and 1 (0–4), respectively, for FED and 6 (3–8) and 1 (0–2), respectively, for MED. The median (IQR Q25–75) pre- and postoperative NRS scores for leg pain were 7 (5–8) and 0 (0–2), respectively, for FED and 6 (5–8) and 0 (0–2), respectively, for MED. These data were not different between the FED and MED groups. The median (IQR Q25–75) DHI ratios of FED and MED were 0.94 (0.89–1.03) and 0.90 (0.79–0.95), respectively. The DHI ratio was significantly higher (p < 0.05) in the FED group than in the MED group, and there was less blood loss; Conclusions: The pain-relieving effect of FED in treating LDH was almost identical to that of MED. However, FED was superior to MED in preventing disc height loss, which is one of the indicators of postoperative disc degeneration.

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Section: Discussionsupporting

confidence: 52%

Comparative Study between Full-Endoscopic Discectomy and Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

et al. 2020

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“…Thus, it is a promising spinal endoscopic technology. Compared with the traditional open surgery for lumbar disc herniation or lumbar spinal stenosis, PTED exhibited the following advantages: [22][23][24][25] minimally invasive surgery under local anesthesia, which reduced the risk of nerve injury due to communication with awake patients; less damage to the lumbar spinal structure and stability, such as the bone, muscle, ligaments, and other soft tissues; reduced intraoperative and postoperative complications; smaller skin incision of 7-8 mm, less bleeding, shorter operative time and hospital stay, early out of bed functional activities, and rapid recovery, thereby greatly reducing the economic burden for patients.…”

Section: Discussionmentioning

confidence: 99%

Accurate location and minimally invasive treatment of lumbar lateral recess stenosis with combined SNRB and PTED

Yue

Shen

et al. 2019

J Int Med Res

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Objective To establish a management strategy for multi-segment lumbar lateral recess stenosis. Methods A retrospective study was performed in patients in whom suspected responsible nerve roots underwent sequential selective nerve root block (SNRB). Based on pain remission rate after blocking, the contribution of nerve root compression to symptoms was classified as absolutely (≥70%) or relatively (30–70%) responsible or non-responsible (<30%). Conservative treatment was continued if visual analogue scale (VAS) at 3 days after blocking a single nerve root or VAS at 3 days after blocking multiple nerve roots was ≥50%; otherwise, percutaneous transforaminal endoscopic discectomy (PTED) was performed. Pain and functional scores were evaluated on day 3, 6 months and 1 year after SNRB or PTED. Results Fifty-seven of 80 patients had a single absolutely responsible root, 20 had 2 responsible roots, and 3 had 3 responsible roots. Among them, 41, 10, and 1 patient underwent PTED, respectively. Both the PTED and conservative groups improved significantly in VAS remission rate and functional scores compared with admission. Moreover, the PTED group had a better VAS remission rate compared with the conservative group. Conclusion A combination of SNRB with PTED was effective for diagnosing and treating multi-segment lumbar lateral recess stenosis.

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“…[25] In contrast, a meta-analysis examining transforaminal endoscopic and microendoscopic discectomy for all herniation types demonstrated lower ODI improvement at one year in the transforaminal group (−0.52 (−0.95 to −0.10), p=0.02), with no difference in pain scores. [26]…”

Section: Lumbar Disc Herniationmentioning

confidence: 99%

Spinal endoscopy: evidence, techniques, global trends, and future projections

et al. 2022

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Percutaneous Transforaminal Endoscopic Discectomy versus Micro-Endoscopic Discectomy for Lumbar Disc Herniation

Cited by 19 publications

References 35 publications

Comparative Study between Full-Endoscopic Discectomy and Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

Comparative Study between Full-Endoscopic Discectomy and Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

Accurate location and minimally invasive treatment of lumbar lateral recess stenosis with combined SNRB and PTED

Spinal endoscopy: evidence, techniques, global trends, and future projections

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