Posterior percutaneous endoscopic lumbar discectomy combined with the vertical anchoring technique for lumbar disc herniation with distant upward migration

Xia, Yu; Zhang, Qiongyue; Gao, Xiang; Wang, Keran; Zhang, Xun; Du, Yu; Chen, Liang

doi:10.1186/s13018-019-1519-9

Cited by 12 publications

(11 citation statements)

References 22 publications

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“…The relative contraindications are hypoplastic pedicle, severe canal stenosis and calcified disc fragments, etc. The posterior approaches are good alternative including -interlaminar approach [ 19 , 27 ] and modified translaminar Osseous Channel approaches [ 25 , 26 ]. For L5-S1 highly upward migrated herniation, we routinely used the posterior interlaminar approach which enable to avoid the obstruction of iliac crest and the embarrassment of working channel angle.…”

Section: Discussionmentioning

confidence: 99%

A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5

Jiang

et al. 2021

BMC Musculoskelet Disord

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Background Percutaneous endoscopic lumbar discectomy (PELD) has become popular for the treatment of symptomatic lumbar disc herniation (LDH). The very highly up-migrated lumbar disc herniation (VHUM-LDH) is difficult to remove under PELD. The purpose of this research is to investigate the feasibility, clinical efficacy and operative nuances of a novel VTT involving TELF for this type of herniation. Methods Eleven patients with very highly up-migrated LDH who underwent VTT involving TELF discectomy from May 2016 to May 2019 were included in this study. The operative time, length of hospital stay, and postoperative complications were recorded. Pre-and postoperative radiologic findings were investigated. All the patients were followed more than 1 year. The visual analogue score (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores and modified MacNab criteria were used to assess surgical efficacy. Results All the 11 patients underwent successful surgery. We compared the VAS, ODI, and JOA scores before and after surgery. The differences were statistically significant (P < 0.05). According to the modified MacNab criteria, 10 patients were assessed as “excellent”, 1 patient was assessed as “good” at the last follow up. Conclusion The novel VTT involving TELF discectomy is a supplement to the traditional PELD. This technique enables the endoscope with working cannula to get closer the sequestrated nucleus pulposus without irritating the exiting nerve root, and facilitates the nucleus pulposus be removed successfully under direct visualization. The VTT involving TELF discectomy can be a safe, effective and feasible surgical procedure for the treatment of LDH with very highly up-migrated.

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Section: Discussionmentioning

confidence: 99%

A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5

Jiang

et al. 2021

BMC Musculoskelet Disord

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“…[5][6][7][8] Several minimal endoscopic techniques have been introduced over the past one or two decades. The issue with these techniques are the prolong surgical time, [9][10][11] potentially higher complications and failure rate, 7,11 requiring careful patient selection [12][13][14] and significant learning curve, thus making it difficult to proceed with the daily routine and no better outcome than conventional surgery. Above all, the outcome is not different Outcome of endoscopic lumbar discectomy for the treatment of sciatica position under general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Endoscopic Lumbar Discectomy for the Treatment of Sciatica

Rehman

Khan

Haq

et al. 2021

JPMI

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Objective: To evaluate the outcome of endoscopic lumbar discectomy in patients having sciatica due to single level prolapsed disc.Methodology: This descriptive study was conducted in neurosurgery departments of Lady Reading Hospital and Hayatabad Medical Complex Peshawar from June 2017 to December 2019, after approval from the ethics committee. All patients with straight leg raising (SLR) less than 60 degree, failed conservative treatment and with single level prolapsed disc were included while redo cases, cauda equine syndrome and traumatic disc prolapse associated with fractures were excluded. Per operative and post operative complications were documented. Patients were followed up for 3 months. Data was collected and analyzed with SPSS version 20.Results: One hundred and fifteen endoscopic lumbar discectomies were done. There were 75 (65.2%) male and 40 (34.8%) female patients. Age range was 17 to 63 years with mean age of 31.0±2.13 years. L5-S1 was involved in 67 (58.26%) cases, L4-5 in 42 (36.52%) cases and L3-4 in 6 (5.22%) cases. Procedure time ranged from 35 to 125 min with a mean of 62 minutes. Four cases were converted to open discectomies due to technical difficulties. Sciatica pain relief was achieved in 110 (95.65%) cases. Surgical site infection was observed in 2 (1.74%) cases. Conclusion:Endoscopic discectomy has acceptable rate of complications and good post-operative pain relief.

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“…PELD is commonly performed using a transforaminal or interlaminar approach [ 3 , 5 ]. For L5/S1 disc herniation, the transformational route is reported to be technically demanding in terms of anatomic constraints in the lumbosacral region, such as a high iliac crest, thickened L5 transverse process, hypertrophied facet joint, and narrowing foramen [ 6 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Gradient local anesthesia for percutaneous endoscopic interlaminar discectomy at the L5/S1 level: a feasibility study

et al. 2020

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Background During the process of shearing the ligamentum flavum, rotating the working channel, and manipulating the annulus fibrosis, the sinuvertebral nerve and the spinal nerve root can be irritated, inducing intolerable back and leg pain. Thus, general anesthesia is recommended and well accepted by most surgeons when performing percutaneous endoscopic lumbar discectomy (PELD) via the interlaminar approach. The aim of our study was to explore the efficacy and safety of percutaneous endoscopy interlaminar lumbar discectomy with gradient local anesthesia (LA) in patients with L5/S1 disc herniation. Methods This retrospective study was conducted between December 2017 and June 2018. The study included 50 consecutive patients who met the study criteria, had single-level L5/S1 disc herniation, and underwent PELD via the interlaminar approach under gradient LA. Different concentrations of local anesthetic compound (LAC) were injected into different tissues inside and outside the ligamentum flavum to complete gradient LA. The evaluation criteria included the intraoperative satisfaction score, visual analog scale (VAS) score, Oswestry Disability Index (ODI), complications, and adverse reactions. Results The intraoperative satisfaction score was consistently over 7, with an average score of 9.3 ± 0.7, indicating that LAC can achieve satisfactory pain control throughout the PELD operation without additional anesthesia. The postoperative VAS score and ODI were dramatically improved at each follow-up interval (P < 0.001, respectively). There was no serious complication such as dural rupture caused by puncture, dural laceration caused by manipulation under endoscopy, total spinal anesthesia, iatrogenic nerve root injury, epidural hematoma, infections, or local anesthetic-related adverse reactions. Three patients experienced transient postoperative dysesthesia of the lower limbs that gradually recovered within 24 h. Conclusions Gradient local anesthesia can satisfactorily and safely control intraoperative pain during the PELD via the interlaminar approach. It can not only improve intraoperative satisfaction, but also reduce local anesthesia-related adverse reactions and surgery-related complications.

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Posterior percutaneous endoscopic lumbar discectomy combined with the vertical anchoring technique for lumbar disc herniation with distant upward migration

Cited by 12 publications

References 22 publications

A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5

A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5

Outcome of Endoscopic Lumbar Discectomy for the Treatment of Sciatica

Gradient local anesthesia for percutaneous endoscopic interlaminar discectomy at the L5/S1 level: a feasibility study

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