Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes.

Autor: Oliveira JAA; Escola de Medicina, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Ramos RRM; Escola de Medicina, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Muniz Neto FJ; Serviço de Radiologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil., Almeida PC; Centro de Ciências da Saúde, Universidade Estadual do Ceará, Fortaleza, CE, Brasil., Ramos MRF; Escola de Medicina, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Carvalho PST; Escola de Medicina, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Jazyk: angličtina
Zdroj: Revista brasileira de ortopedia [Rev Bras Ortop (Sao Paulo)] 2021 Oct 13; Vol. 57 (1), pp. 55-60. Date of Electronic Publication: 2021 Oct 13 (Print Publication: 2022).
DOI: 10.1055/s-0041-1732387
Abstrakt: Objectives  To evaluate the correlation between radiologic changes (Pfirrmann and Modic) and radicular pain intensity in patients who underwent transforaminal endoscopic surgery for lumbar disc herniation. Methods  Series of cases with 39 patients, 50 intervertebral discs in preoperative evaluation from January 29, 2018 to August 28, 2019 in an endoscopic spine surgery service. Demographic data, surgical indication, operative details and complications were obtained from medical records. The patients were divided into three groups based on the Modic classification (Modic absence, Modic 1 and Modic 2) and into two groups considering the Pfirrmann classification (Pfirrmann IV and Pfirrmann V). Data were processed in IBM SPSS Statistics for Windows, Version 22.0 (IBM Corp., Armonk, NY, USA), with a significance level of p  < 0,05. Results  There was no difference between genders; age: 50,36 ± 15,05 years old; disease level: L2-L3 1 (2%), L3-L4 2 (4%), L4-L5 9 (18%), L5-S1 8 (16%), L3-L4 + L4-L5 4 (8%), and L4-L5 + L5-S1 26 (52%); location: right foraminal 7 (14%), left foraminal 15 (30%), central 9 (18%) and diffuse 19 (38%); radicular pain: left 25 (50%), right 11 (22%), and bilateral 14 (28%); preoperative visual analogue scale (VAS): 9,5 ± 0,91, postoperative: 2,5 ± 1,79; surgery duration: 100 ± 31,36 minutes; and follow-up: 8,4 ± 6,7 months. Less postoperative sciatica was registered in the Modic 2 versus Modic 1 group ( p  < 0,05). There was no difference in the postoperative radicular pain between the Pfirrmann groups (IV versus V). Conclusion  Although there is no clinical difference between the groups, in advanced stages of disc degeneration, endoscopic transforaminal discectomy proved to be effective in diminishing radicular pain in patients with lumbar disc herniation.
Competing Interests: Conflito de Interesses Os autores declaram não haver conflitos de interesses.
(Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)
Databáze: MEDLINE
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