The role of transforaminal percutaneous endoscopic discectomy in lumbar disc herniations

Abstract

Objectives:To study 1)the efficacy of transforaminal percutaneous endoscopic lumbar discectomy in lumbar disc herniations.2) limitations and advantages of the surgical procedure. 3)morbidity and complications associated with the procedure.Materials and Methods:This study was carried out on 120 patients who had single level herniated disc Pre-operative assessment of VAS and MSS scoring systems were documented one day prior to surgery. Post operative results were determined by MacNab criteria and by modified Suezawa and Schreiber clinical scoring system (MSS score).Results:Maximum patients were in the age group of 31 to 40 years and 83.43% of the patients were males. 80% patients had lumbar disc herniation at L4-L5 level, The mean operative time of endoscopic discectomy was 52.28 minutes and the mean hospital stay was 2.1days.8 cases of L5-S I were abandoned due to high iliac bone and hence their disc could not be accessed. Out of 112 patients who underwent operation, 2 patients developed discitis and 1 was found to have dysesthesia. Also recurrent prolapsed intervertebral disc was seen in 6 cases The mean preoperative and 6 months follow-up VAS score was 8.4 and 1.89 respectively. Mean preoperative and 6 months follow-up Modified Suezawa And Schreiber Clinical Scoring System(MSS Score) was 3.47 and 7.92 respectively. MSS score showed excellent and good outcome in 82.12% patients and Modified Macnab Criteria showed excellent and good outcome in 89.3% patients at 6months follow-up.Conclusion:TPELD can be a reasonable alternative to conventional microscopic discectomy for the treatment of patients with LDH. We also conclude that TPELD is not an effective procedure for L5-S 1 disc and an open procedure should be opted for better outcomes.

Therapeutic effect of percutaneous endoscopic lumbar discectomy on lumbar disc herniation and its effect on oxidative stress in patients with lumbar disc herniation

“…Open discectomy is used as the main treatment of lumbar disc herniation, but the application of open discectomy is limited by the big surgical trauma and the incidence of postoperative complications including adhesions of nerve roots and lumbar instability (10). In order to reduce the damage of normal tissue caused by surgical operations and the incidence of postoperative complications, percutaneous endoscopic lumbar discectomy has been widely applied and is attracting increased attention.…”

Full Endoscopic Discectomy Using Transforaminal Endoscopic Spine System Technique: A Mini Review of Complications

“…Gotecha et al investigated the morbidity and was found in one other patient. Re-herniation of the intervertebral disc was also noted in 6 cases [18]. Wu et al emphasized on the difficulty of approach of L5-S1 level using FED.…”

“…The appropriate way to avoid this complication is the sufficient knowledge of clinical anatomy, especially for the inexperienced spine surgeon. After a pain-free period, the main problem is the re-herniation of the intervertebral disc [18]. The recurrence rate is similar to that of microdiscectomy and it ranges from 3 to 7% [12].…”

“…The recurrence rate is similar to that of microdiscectomy and it ranges from 3 to 7% [12]. The period of recurrence ranges from 3 to 18 months after the performance of spine surgery [10,18,42] The complete and careful removal of the hernia mass constitutes the optimum condition to reduce the probability of recurrence [33].…”

A comparison between remaining and resecting the posterior longitudinal ligament in percutaneous endoscopic transforaminal discectomy for disc herniation: A retrospective cohort study

“…For decades, minimally invasive spine surgery has been increasingly popular in treating LDH for multiple advantages compared with the open technique: such as less invasive, decreased blood loss, faster function recovery, shorter length of hospitalization, and lower risk of spinal instability [9][10][11].PETD via inside-and-out approach has become one of the most common minimally invasive spinal surgeries since Yeung et al developed the spinal endoscopic YESS system in 2002 [7,12].Many studies have indicated that this technique could achieve good results with effective nerve root decompression, low complication rates for most types of LDH [13][14][15][16]. Yeung et al [7] reported 307 cases of LDH treated with the this technique followed-up for more than one year, and the excellent -to -good rate was 89.3%.…”