CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(01): 048-053
DOI: 10.1055/s-0039-1700822
Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Transforaminal Endoscopic Lumbar Discectomy: Clinical Outcomes and Complications[*]

Article in several languages: português | English
1   Faculdade de Medicina do ABC, Santo André, SP, Brasil
,
João Paulo Machado Bergamaschi
2   Clínica Kennedy, São Paulo, SP, Brasil
,
Álvaro Dowling
2   Clínica Kennedy, São Paulo, SP, Brasil
,
Luciano Miller Reis Rodrigues
1   Faculdade de Medicina do ABC, Santo André, SP, Brasil
› Author Affiliations
Further Information

Publication History

20 September 2018

22 January 2019

Publication Date:
28 February 2020 (online)

Abstract

Objective To evaluate the clinical and functional results of transforaminal endoscopic lumbar discectomy.

Materials and Methods From August 2015 to January 2017, 101 patients with lumbar disc hernia refractory to clinical treatment underwent endoscopic discectomy. Through clinical evaluation by the Visual Analogue Scale and functional evaluation by the Oswestry Disability Index questionnaire, the patients were analyzed in the preoperative period, the immediate postoperative period, at 1 month, 3 months, 6 months and 1 year after surgery.

Results The mean age of the participants was 48.1 years. The most affected disc levels were L4-L5 and L5-S1. A total of 29 patients were treated at 2 disc levels. After 1 month of postoperative follow-up, the mean scores on the questionnaires (VAS and ODI) decreased significantly (p < 0.001).

Conclusion Transforaminal endoscopic Lumbar discectomy has been shown to be a safe, effective and minimally-invasive alternative for the treatment of lumbar disc herniation. The procedure has advantages, such as short hospital stay, surgery performed under local anesthesia and sedation, early return to daily activities, and low rate of complications.

* Work developed At Faculdade de Medicina do ABC, Santo André, SP, Brazil.


 
  • Referências

  • 1 Andersson GB. Epidemiological features of chronic low-back pain. Lancet 1999; 354 (9178): 581-585
  • 2 Papageorgiou AC, Croft PR, Ferry S, Jayson MI, Silman AJ. Estimating the prevalence of low back pain in the general population. Evidence from the South Manchester Back Pain Survey. Spine 1995; 20 (17) 1889-1894
  • 3 Konstantinou K, Dunn KM. Sciatica: review of epidemiological studies and prevalence estimates. Spine 2008; 33 (22) 2464-2472
  • 4 Spangfort EV. The lumbar disc herniation. A computer-aided analysis of 2,504 operations. Acta Orthop Scand Suppl 1972; 142: 1-95
  • 5 Mixter WJ, Barr J. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med 1934; 211: 208-215
  • 6 Hijikata S. Percutaneous nucleotomy. A new concept technique and 12 years' experience. Clin Orthop Relat Res 1989; (238) 9-23
  • 7 Kambin P, Schaffer JL. Percutaneous lumbar discectomy. Review of 100 patients and current practice. Clin Orthop Relat Res 1989; (238) 24-34
  • 8 Foley KT, Smith MM. Microendoscopic Discectomy. Tech Neurosurg 1997; 3: 301-307
  • 9 Jhala A, Mistry M. Endoscopic lumbar discectomy: Experience of first 100 cases. Indian J Orthop 2010; 44 (02) 184-190
  • 10 Yeung AT. Minimally Invasive Disc Surgery with the Yeung Endoscopic Spine System (YESS). Surg Technol Int 1999; 8: 267-277
  • 11 Maroon JC. Current concepts in minimally invasive discectomy. Neurosurgery 2002; 51 (5, Suppl) S137-S145
  • 12 Caspar W. A new surgical procedure for lumbar disc herniation causing less tissue damage through microsurgical approach. In: Wullenweber R, Brock M, Hamer J, Klinger M, Spoerri O. , editors. Advances in Neurosurgery. Berlin: Springer-Verlag; 1977: 74-77
  • 13 Kraemer R, Wild A, Haak H, Herdmann J, Krauspe R, Kraemer J. Classification and management of early complications in open lumbar microdiscectomy. Eur Spine J 2003; 12 (03) 239-246
  • 14 Acharya KN, Nathan TS, Kumar JR, Menon KV. Primary and revision lumbar discectomy: a three-year review from one center. Indian J Orthop 2008; 42 (02) 178-181
  • 15 Kulkarni AG, Bassi A, Dhruv A. Microendoscopic lumbar discectomy: Technique and results of 188 cases. Indian J Orthop 2014; 48 (01) 81-87
  • 16 Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: Surgical technique, outcome, and complications in 307 consecutive cases. Spine 2002; 27 (07) 722-731
  • 17 Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine 2008; 33 (09) 931-939
  • 18 Chae KH, Ju CI, Lee SM, Kim BW, Kim SY, Kim HS. Strategies for Noncontained Lumbar Disc Herniation by an Endoscopic Approach : Transforaminal Suprapedicular Approach, Semi-Rigid Flexible Curved Probe, and 3-Dimensional Reconstruction CT with Discogram. J Korean Neurosurg Soc 2009; 46 (04) 312-316
  • 19 Kaushal M, Sen R. Posterior endoscopic discectomy: Results in 300 patients. Indian J Orthop 2012; 46 (01) 81-85
  • 20 Cong L, Zhu Y, Tu G. A meta-analysis of endoscopic discectomy versus open discectomy for symptomatic lumbar disk herniation. Eur Spine J 2016; 25 (01) 134-143
  • 21 Choi KC, Lee JH, Kim JS. , et al. Unsuccessful percutaneous endoscopic lumbar discectomy: a single-center experience of 10,228 cases. Neurosurgery 2015; 76 (04) 372-380 , discussion 380–381, quiz 381
  • 22 Wang H, Huang B, Li C. , et al. Learning curve for percutaneous endoscopic lumbar discectomy depending on the surgeon's training level of minimally invasive spine surgery. Clin Neurol Neurosurg 2013; 115 (10) 1987-1991
  • 23 Wu XB, Fan GX, Gu X. , et al. Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study. J Zhejiang Univ Sci B 2016; 17 (07) 553-560
  • 24 Hsu HT, Chang SJ, Yang SS, Chai CL. Learning curve of full-endoscopic lumbar discectomy. Eur Spine J 2013; 22 (04) 727-733