Early Clinical Outcomes of Percutaneous Endoscopic Lumbar Discectomy for L4-5 Highly Down-Migrated Disc Herniation: Interlaminar Approach Versus Transforaminal Approach
| Autor: | Honglin Teng, Minyu Zhu, Guoliang Chen, Sheng Lu, Bi Chen, Shiyang Wu, Jinwei Ying, Chaowei Lin, Kelun Huang, Yu Wang |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Disc herniation Percutaneous Endoscope Visual analogue scale Lumbar discectomy 03 medical and health sciences 0302 clinical medicine Humans Medicine Diskectomy Percutaneous Retrospective Studies Lumbar Vertebrae business.industry Endoscopy Middle Aged Oswestry Disability Index Surgery Treatment Outcome 030220 oncology & carcinogenesis Female Neurology (clinical) Complication business Transforaminal approach Intervertebral Disc Displacement 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | World Neurosurgery. 146:e413-e418 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2020.10.105 |
| Popis: | Objective This study is a retrospective evaluation of patients with L4-5 highly down-migrated lumbar disc herniation (LDH) operated with interlaminar endoscopic lumbar discectomy (IELD) versus transforaminal endoscopic lumbar discectomy (TELD). Methods From January 2015 to December 2018, 77 patients with L4-5 highly down-migrated LDH were divided into 2 groups according to different surgical approaches. There were 40 patients who underwent IELD, and 37 patients who underwent TELD. The operation time, hospital stay, Oswestry Disability Index, clinical outcome according with modified MacNab criteria, Visual Analog Scale (VAS) scores, and complications were compared between the IELD and TELD groups. Results Seventy-seven patients were included, 40 and 37 patients underwent IELD and TELD, respectively. The IELD and TELD groups both achieved a significant improvement in Oswestry Disability Index, back and leg VAS scores, and clinical outcome postoperation. Mean operating and x-ray times during operation were significantly shorter in the IELD group than in the TELD group (41.8 vs. 50.3, 1.8 vs. 13.7). There were 3 patients who experienced recurrence in the IELD group and 2 in the TELD group. In the TELD group, there were 3 patients who required revision surgery due to incompletely removed disc fragment. All patients in the IELD group were treated successfully. There was no other complication in these cases. Conclusions Both IELD and TELD could be a good alternative option for highly down-migrated LDH in L4-L5. IELD may have advantages in operation time and x-ray times during operation compared with TELD. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect