J Neurol Surg A Cent Eur Neurosurg 2018; 79(04): 285-290
DOI: 10.1055/s-0038-1639503
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Outcome Predictors of the Transforaminal Endoscopic Spine System Technique for Single-level Lumbar Disk Herniation

Jinchun Wu
1  Department of Orthopedics, Jingjiang People's Hospital, Jingjiang, China
,
Bin Yu
2  Department of Spine Surgery, Shanghai East Hospital, Shanghai, China
,
Bin He
1  Department of Orthopedics, Jingjiang People's Hospital, Jingjiang, China
,
Gang Liu
1  Department of Orthopedics, Jingjiang People's Hospital, Jingjiang, China
,
Jidong Ju
1  Department of Orthopedics, Jingjiang People's Hospital, Jingjiang, China
,
Jianguang Zhu
2  Department of Spine Surgery, Shanghai East Hospital, Shanghai, China
› Author Affiliations
Further Information

Publication History

18 April 2017

09 November 2017

Publication Date:
12 April 2018 (online)

Abstract

Background Endoscopic spine surgery has become increasingly popular. However, no study has researched the predictive factors for different outcomes. This study is the first to evaluate the outcome predictors of the transforaminal endoscopic spine system (TESSYS) technique for lumbar disk herniation (LDH).

Methods We performed a prospective study of 80 patients meeting the inclusion criteria who underwent TESSYS for LDH. Clinical outcomes were assessed by the visual analog scale (VAS), the Oswestry Disability Index (ODI), and the modified MacNab criteria. Univariate and multivariate analyses were performed to evaluate the outcome predictors.

Results There were 36 men and 44 women with a mean age of 48.76 ± 15.60 years (range: 24–78 years). The mean follow-up time was 25.15 ± 9.76 months (range: 12–48 months). The VAS and ODI scores at the last follow-up were significantly improved (p < 0.001). Based on the modified MacNab criteria, the global outcomes were excellent in 34 patients (42.5%), good in 26 patients (32.5%), fair in 11 patients (13.75%), and poor in 9 patients (11.25%). The percentage of symptomatic improvement was 88.75%, and the success rate (excellent or good) was 75%. In the univariate and multivariate analyses, LDH with older age (odds ratio [OR]: 6.621; 95% confidence interval [CI], 0.632–20.846; p = 0.019), high-intensity zone (HIZ) (OR: 8.152; 95% CI, 0.827–4.380; p = 0.003), and larger disk herniation (OR: 6.819; 95% CI, 0.113–4.825; p = 0.017) were the most significant negative outcome predictors.

Conclusions TESSYS is an effective method to treat LDH. Older age, the existence of an HIZ, and a large disk herniation were the most important predictors for a worse outcome.