Back
 IJCM  Vol.11 No.3 , March 2020
The Clinical Effect of Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Low Lumbar Single Segment Disc Herniation
Abstract: Objective: To observe the clinical effect percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of single lumbar disc herniation. Methods: From August 2017 to June 2019, 42 patients with low lumbar single segment lumbar disc herniation were treated with percutaneous transforaminal endoscopic discectomy surgery in our hospital. The operation time, incision size, bleeding volume and hospitalization time were recorded respectively. The patients were evaluated before operation, 1 month and 6 months after operation. Visual analogue scale (VAS) and assessment were used to evaluate the lumbocrural pain. The JOA score and the Oswestry disability index (ODI) were used to evaluate the lumbar function, and the modified macnab score was used to evaluate the clinical effect in the last follow-up. Results: All the 42 patients successfully completed the operation without any other operation. There were no severe complications such as dural injury and nerve root injury. The operation time was (76.98 ± 8.58) min, the incision size was (8.45 ± 1.2) mm, the bleeding volume was (20.14 ± 2.93) ml, and the hospitalization time was (4.55 ± 1.13) d. One month and six months after the operation, the visual analogue scale (VAS), the evaluation of lumbar function (Oswestry) and the disability index (ODI) were significantly improved compared with those before the operation (P < 0.05). The last follow-up evaluation of the clinical effect of modified macnab: excellent in 30 cases, good in 8 cases, fair in 3 cases and poor in 1 case. The excellent rate was 90.47%. One patient developed back pain and discomfort. One case recurred. Conclusion: The treatment of low lumbar but segmental lumbar disc herniation with percutaneous intervertebral foramen, with small incision, less bleeding and quick recovery, can improve the pain and dysfunction of patients.
Cite this paper: Yang, L. and Zou, S. (2020) The Clinical Effect of Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Low Lumbar Single Segment Disc Herniation. International Journal of Clinical Medicine, 11, 119-125. doi: 10.4236/ijcm.2020.113012.
References

[1]   Xu, F., Zhang, T.H., Cai, X.H., et al. (2017) Treatment of Double Segment Lumbar Disc Herniation by Percutaneous Endoscopic Discectomy. Journal of Spine Surgery, 15, 13-17.

[2]   Liu, X., Wang, F., Zhao, X.D., et al. (2017) MRI Measurement of the Relationship between Disc Degeneration and Dural Sac Transection Area in Lumbar Spinal Stenosis. Journal of Practical Medicine, 33, 2332-2335.

[3]   Macnab, I. (1971) Negative Disc Exploration. An Analysis of the Causes of Nerve-Root Involvement in Sixty-Eight Patients. Journal of Bone and Joint Surgery, 53, 891-903.
https://doi.org/10.2106/00004623-197153050-00004

[4]   Zhou, M.W., Yue, S.W., et al. (2017) Chinese Expert Consensus on the Rehabilitation of Lumbar Disc Herniation. Chinese Journal of Rehabilitation Medicine, 32, 129-135.

[5]   Ruetten, S., Meyer, O. and Godolias, G. (2002) Epiduroscopic Diagnosis and Treatment of Epidural Adhesions in Chronic Back Pain Syndrome of Patients with Previous Surgical Treatment: First Results of 31 Interventions. Zeitschrift für Orthopädie und ihre Grenzgebiete, 140, 171-175.
https://doi.org/10.1055/s-2002-31536

[6]   Strömqvist, F., Strömqvist, B., Bo, J., et al. (2016) Gender Differences in Patients Scheduled for Lumbar Disc Herniation Surgery: A National Register Study Including 15,631 Operations. European Spine Journal, 25, 162-167.
https://doi.org/10.1007/s00586-015-4052-5

[7]   Kambin, P. and Gellman, H. (1983) Percutaneous Lateral Discectomy of the Lumbar Spine: A Preliminary Report. Archives of Orthopaedic and Trauma Surgery, 101, 219-221.

[8]   Tan, L.Y. and Xu, F. (2018) Analysis of the Therapeutic Effect of Percutaneous Intervertebral Foraminal Surgery on Lumbar Disc Herniation with Ossification of Posterior Longitudinal Ligament. Chinese Journal of Clinical Neurosurgery, 23, 788-791.

[9]   Yeung, A.T. and Tsou, P.M. (2002) Posterolateral Endoscopic Excision for Lumbar Disc Herniation: Surgical Technique, Outcome, and Complications in 307 Consecutive Cases. Spine (Phila Pa 1976), 27, 722-731.
https://doi.org/10.1097/00007632-200204010-00009

[10]   Zhou, Y., Li, C.Q., Wang, J., et al. (2010) Treatment of Lumbar Disc Herniation with Yess and Tessys. Chinese Journal of Orthopaedics, 30, 225-231.

[11]   Cheng, J.W., Wang, Z.L., Liu, W., Xing, Y.M., Li, C.Z., Li, C.Q. and Zhou, Y. (2017) Improvement and Reliability and Validity Test of Oswestry Dysfunction Index. Chinese Journal of Spine and Spinal Cord, 27, 235-241.

[12]   Wang, J.X., Shao, S.L., Wu, J.G., et al. (2019) The Efficacy of Percutaneous Transaminal Endoscopic Surgery in the Treatment of Recurrent Lumbar Disc Herniation. Chinese Medical Journal, Chinese Journal of Minimally Invasive Surgery, 19, 251-255.

 
 
Top