Surgical Outcome of Percutaneous Endoscopic Interlaminar Lumbar Diskectomy for Recurrent Disk Herniation After Open Diskectomy

Kim, Chi Heon; Chung, Chun Kee; Jahng, Tae-Ahn; Yang, Hee-Jong; Son, Young Hoon

doi:10.1097/bsd.0b013e31825bd111

Cited by 43 publications

(48 citation statements)

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“…Surgery in the case of a herniated disk can produce many symptoms, whether local or distant from the scar, regardless of the surgical procedure adopted 74,75. The periradicular and epidural scar resulting from surgery prevents the nerve from sliding properly during the movement of the lower limbs; this, along with a decreased vascular supply recorded during the mechanical action, produces pain 76,77.…”

Section: Symptoms and Clinical Scenarios: Lumbar Surgerymentioning

confidence: 99%

Skin, fascias, and scars: symptoms and systemic connections

Bordoni

Zanier²

2013

JMDH

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Every element or cell in the human body produces substances that communicate and respond in an autocrine or paracrine mode, consequently affecting organs and structures that are seemingly far from each other. The same also applies to the skin. In fact, when the integrity of the skin has been altered, or when its healing process is disturbed, it becomes a source of symptoms that are not merely cutaneous. The skin is an organ, and similar to any other structure, it has different functions in addition to connections with the central and peripheral nervous system. This article examines pathological responses produced by scars, analyzing definitions and differences. At the same time, it considers the subcutaneous fascias, as this connective structure is altered when there is a discontinuous cutaneous surface. The consequence is an ample symptomatology, which is not limited to the body area where the scar is located, such as a postural or trigeminal disorder.

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Section: Symptoms and Clinical Scenarios: Lumbar Surgerymentioning

confidence: 99%

Skin, fascias, and scars: symptoms and systemic connections

Bordoni

Zanier²

2013

JMDH

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“…7 A revision discectomy is technically demanding due to scarring tissue, unclear anatomic planes, and re-traumatization to the posterior structures. 12,13 Although open microdiscectomy is a standard method for fragmentectomy, [14][15][16] endoscopic techniques have emerged as surgical alternatives with comparable results. The remaining epidural scar did not seem to cause residual radicular pain.…”

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confidence: 99%

“…[7][8][9][10][11] The aim of a revision discectomy is not scar tissue removal, but the removal of the disk fragment. [10][11][12]15,17 The problems related to scar tissue and re-traumatization of the posterior structures can be overcome with the endoscopic method. 12,13 Although open microdiscectomy is a standard method for fragmentectomy, [14][15][16] endoscopic techniques have emerged as surgical alternatives with comparable results.…”

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confidence: 99%

“…The remaining epidural scar did not seem to cause residual radicular pain. 10,12,15,17 A percutaneous endoscopic lumbar discectomy (PED) can be performed by either the transforaminal route (PETD) or the interlaminar route (PEID). [10][11][12]15,17 The problems related to scar tissue and re-traumatization of the posterior structures can be overcome with the endoscopic method.…”

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confidence: 99%

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The Surgical Outcome and the Surgical Strategy of Percutaneous Endoscopic Discectomy for Recurrent Disk Herniation

Kim¹,

Chung²,

Sohn³

et al. 2014

Journal of Spinal Disorders &Amp; Techniques

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“…An endoscope is used to help perform release and decompression within the spinal canal through intervertebral foramen, combining traditional posterior-lateral lumbar intervertebral disk treatment techniques and spinal endoscopic techniques. It provides a new solution for treating this type of herniation (8–10). The purpose of this study was to investigate the effects of release and decompression techniques during percutaneous transforaminal endoscopic discectomy (PTED) in treating CLDH.…”

Section: Introductionmentioning

confidence: 99%

Effects of release and decompression techniques on nerve roots through percutaneous transforaminal endoscopic discectomy on patients with central lumbar disc herniation

Qiang-jun

Cheng

et al. 2017

Experimental and Therapeutic Medicine

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The clinical effects and safety of release and decompression techniques on nerve roots through percutaneous transforaminal endoscopic discectomy (PTED) while treating patients with central lumbar disc herniation (CLDH) were explored. Patient cases of lumbar and leg pain treated in Bethune International Peace Hospital from July 2013 to October 2015 were collected retrospectively. The patients in these cases received imaging examinations such as computed tomography and magnetic resonance imaging. Among these cases, 37 CLDH patients with no other complications were selected for this study. A total of 22 males and 15 females aged 28–54 years, with an average age of 36.8±1.5 years, were the subjects of the study. Their disease course was from 1 month to 3 years, with a median course time of 1.5 years. Visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) scoring and the MacNab method were used to evaluate treatment effects. After permission from patients or their family members, release and decompression techniques of nerve roots were performed through PTED. All patients had successful surgery. Their average surgery time was 41.3 (25.5–57.1) min. A physician followed-up each patient from 0 to 18 months after surgery, with the average follow-up period of 12.1 months. VAS scoring of lower limbs was 7.95±0.82 before surgery and 2.28±0.35, 3 months after surgery. VAS scoring of lower limbs was 2.06±0.58, 1 year after surgery and 2.12±0.23 at the last follow-up appointment. JOA scoring was 12.6±0.72 before surgery and 20.4±1.08, 3 months after surgery. JOA scoring was 21.1±0.82 1 year after surgery and 21.2±0.36 at the last follow-up. Differences are of statistical significance (P<0.05). There were no complications for any of the cases. One patient did not improve after surgery, so a laminectomy and bone grafting internal fixation were performed. Two patients relapsed after surgery and received laminectomy and bone grafting internal fixation. The total percentage of excellent and good rates was 83.5%. In conclusion, release and decompression techniques on nerve roots using PTED while treating CLDH resulted in a safe, effective and less traumatic outcome with fewer complications and quicker pain relief than alternative treatments. Due to the results of this study, the use of these techniques in treating CLDH should be more widely considered.

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Surgical Outcome of Percutaneous Endoscopic Interlaminar Lumbar Diskectomy for Recurrent Disk Herniation After Open Diskectomy

Abstract: PEID with dissection of the scar tissue from the medial facet joint rather than from the neural tissue may be an effective alternative surgical method for recurrent disk herniation.

Cited by 43 publications

References 0 publications

Skin, fascias, and scars: symptoms and systemic connections

Skin, fascias, and scars: symptoms and systemic connections

The Surgical Outcome and the Surgical Strategy of Percutaneous Endoscopic Discectomy for Recurrent Disk Herniation

Effects of release and decompression techniques on nerve roots through percutaneous transforaminal endoscopic discectomy on patients with central lumbar disc herniation

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