Transpedicular Lumbar Endoscopic Surgery for Highly Migrated Disk Extrusions: Preliminary Series and Surgical Technique
| Autor: | Albert E. Telfeian, Menno Iprenburg, Guntram Krzok, Ralf Wagner |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Endoscopic surgery Transpedicular approach Lumbar herniated disk 03 medical and health sciences 0302 clinical medicine Lumbar Female patient Humans Medicine Diskectomy Percutaneous 030212 general & internal medicine Aged Pain score Lumbar Vertebrae business.industry Endoscopy Middle Aged medicine.disease Surgery Radicular pain Female Neurology (clinical) Radiology business Endoscopic treatment Intervertebral Disc Displacement 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 95:299-303 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2016.08.018 |
| Popis: | Objective Endoscopic surgery for highly migrated lumbar disk extrusions is a challenge even for spine surgeons who are familiar with using endoscopic techniques. Because of the anatomic constraints involved in transforaminal access in endoscopic surgery, an incomplete removal of a highly migrated disk extrusion can result in some cases. Here the authors describe a new technique for accessing extruded lumbar disks that have migrated into the canal directly through a transpedicular approach. Methods A technique for the endoscopic treatment of highly migrated lumbar disk extrusions is presented. Retrospectively, we reviewed a series of 21 consecutive patients operated on with lumbar 3-4, lumbar 4-5, and lumbar 5−sacral 1 highly migrated disk extrusions: preoperative and postoperative clinical data with 1-year follow-up. Results A preliminary series of 11 male and 10 female patients with an average age of 56.9 years (from 33–78 years old) who underwent transpedicular endoscopic retrieval of an extruded lumbar disk between 2012 and 2015 is presented. Two patients required revision to transforaminal access, 1 at the same sitting and the other 4 weeks later. The mean visual analog scale score for radicular pain improved from an average pain score before surgery of 8.1–1.7 one year after surgery. No pedicle fractures were encountered. Conclusions Transpedicular endoscopic access to highly migrated lumbar herniated disk extrusions is presented as a unique minimally invasive approach to extruded lumbar herniated disks, especially at L3-4, L4-5, and L5-S1. |
| Databáze: | OpenAIRE |
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