Subscribe to RSS
Endoscopic Lumbar Discectomy Using Side-Viewing Conical Working Tube: An Institutional Experience
Objective The paradigm of surgical therapy for spinal disease especially for lumbar disc herniation (LDH) has gradually shifted from the traditional open surgeries to minimal invasive spinal surgeries. Endoscopic discectomy has been performed widely using various devices and techniques. In this study we present our experience of endoscopic discectomy using a unique device with separate side-viewing channel.
Methods Twenty-six patients with LDH treated between March 2015 and April 2018 using the unique conical working tube with separate side-viewing endoscopic channel have been retrospectively analyzed. Their preoperative and postoperative Oswestry Disability Index (ODI) and Macnab scores were used to evaluate the outcome with a mean follow-up of 37.04 months.
Results There were 18 males and 8 females with age ranging from 19 to 72 years (mean, 38.4 years). The follow-up ranged from 25 to 60 months with mean of 37.04 months. The mean preoperative ODI score was 72.4, which decreased to a mean of 7.6 and the outcome evaluated by Macnab criteria was 65.3% excellent, 19.2% good, 11.5% fair, and 3.8% poor. One patient underwent second surgery. None of the patients had to change their occupation postoperatively. Complications that occurred were dural tear in one patient and transient foot paresis in one, which improved spontaneously.
Conclusion Endoscopic discectomy using conical working tube is a safe and effective technique for lumbar disc prolapse. The long-term results are comparable to the conventional techniques.
Article published online:
13 January 2022
© 2021. Neurological Surgeons' Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
- 1 Li X, Hu Z, Cui J. et al. Percutaneous endoscopic lumbar discectomy for recurrent lumbar disc herniation. Int J Surg 2016; 27: 8-16
- 2 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
- 3 Hoogland T, Schubert M, Miklitz B, Ramirez A. Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine 2006; 31 (24) E890-E897
- 4 Destandau J. [Technical features of endoscopic surgery for lumbar disc herniation: 191 patients]. Neurochirurgie 2004; 50 (01) 6-10
- 5 Destandau J. A special device for endoscopic surgery of lumbar disc herniation. Neurol Res 1999; 21 (01) 39-42
- 6 Lysoń T, Mariak Z, Jadeszko M, Kochanowicz J, Lewko J. Results of Destandau microendoscopic lumbar discectomy. Neurol Neurochir Pol 2008; 42 (02) 105-111
- 7 Bhandari S. Early experiences in endoscopic lumbar discectomy by Destandau technique for prolapse intervertebral disc. J Maharashtra Orthop Assoc. 2006; 4: 174-179
- 8 Husain M, Jha DK, Agrawal S, Husain N, Gupta RK. Conical working tube: a special device for endoscopic surgery of herniated lumbar discs. J Neurosurg Spine 2005; 2 (03) 265-270
- 9 Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med 1934; 211: 210-215
- 10 Smith MM, Foley KT. Microendoscopic discectomy (MED): surgical technique and initial clinical results. Proceedings of the Thirteen Annual Meeting of the joint section of Disorders of the Spine and Peripheral Nerve of the American Association of Neurological Surgeons; 1997 Feb; Newport Beach, CA
- 11 Williams RW. Microlumbar discectomy: a conservative surgical approach to the virgin herniated lumbar disc. Spine 1978; 3 (02) 175-182
- 12 Howe J, Frymoyer JW. The effects of questionnaire design on the determination of end results in lumbar spinal surgery. Spine 1985; 10 (09) 804-805
- 13 Kambin P, Brager MD. Percutaneus posterolateral discectomy. Anatomy and mechanism. Clin Orthop Relat Res 1987; 223: 145-154
- 14 Hijikata S, Yamagishi M, Nakayama T, Oomori K. Percutaneous nucleotomy: a new treatment method for lumbar disc herniation. J Toden Hop 1975; 5: 5-13
- 15 Kim M, Kim H-S, Oh SW. et al. Evolution of spinal endoscopic surgery. Neurospine 2019; 16 (01) 6-14
- 16 Kulkarni AG, Dhruv A, Bassi A. Microendoscopic lumbar discectomy : Technique and results of 188 cases. Indian J Orthop 2014; 48 (01) 81-87
- 17 Hussein M, Abdeldayem A, Mattar MM. Surgical technique and effectiveness of microendoscopic discectomy for large uncontained lumbar disc herniations: a prospective, randomized, controlled study with 8 years of follow-up. Eur Spine J 2014; 23: 1992-1999
- 18 Li Z.-Z., Hou S.-X., Shang W.-L., Song K.-R., Zhao H.-L.. “The strategy and early clinical outcome of full-endoscopic L5/S1 discectomy through interlaminar approach,”. Clinical Neurology and Neurosurgery 2015; 133: 40-45
- 19 Choi KC, Kim JS, Park CK. Percutaneous Endoscopic Lumbar Discectomy as an Alternative to Open Lumbar Microdiscectomy for Large Lumbar Disc Herniation. Pain Physician 19 (02) E291-E300
- 20 Eun SS, Lee SH, Sabal LA. Long-term Follow-up Results of Percutaneous Endoscopic Lumbar Discectomy. Pain Physician 2016; Nov-Dec; 19 (08) E1161-E1166
- 21 Choi KC, Lee DC, Shim HK, Shin SH, Park CK. A Strategy of Percutaneous Endoscopic Lumbar Discectomy for Migrated Disc Herniation. World Neurosurgery 99: 259-266
- 22 Kaif M, Yadav K, Husain M. Long term results of Endoscopic Lumbar Discectomy using Side viewing Conical working tube. Romanian Neurosurgery 2018; XXXII (02) 306-313
- 23 Kim HS, Paudel B, Jang JS, Lee K, Oh SH, Jang IT. Percutaneous Endoscopic Lumbar Discectomy for All Types of Lumbar Disc Herniations (LDH) Including Severely Difficult and Extremely Difficult LDH Cases. Pain Physician 2018; 21 (04) E401-E408
- 24 Liu C, Zhou Y. Percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion for massive lumbar disc herniation. Clin Neurol Neurosurg 2019; 176: 19-24
- 25 Li Z, Zhang C, Chen W. et al. Percutaneous Endoscopic Transforaminal Discectomy versus Conventional Open Lumbar Discectomy for Upper Lumbar Disc Herniation: A Comparative Cohort Study. Biomed Res Int 2020; 2020: 1852070
- 26 Jensdottir M, Gudmundsson K, Hannesson B, Gudmundsson G. 20 years follow-up after the first microsurgical lumbar discectomies in Iceland. Acta Neurochir (Wien) 2007; 149 (01) 51-58 , discussion 57–58(wein)
- 27 Casal-Moro R, Castro-Menéndez M, Hernández-Blanco M, Bravo-Ricoy JA, Jorge-Barreiro FJ. Long-term outcome after microendoscopic diskectomy for lumbar disk herniation: a prospective clinical study with a 5-year follow-up. Neurosurgery 2011; 68 (06) 1568-1575 , discussion 1575
- 28 Bhaisare R, Kamble B, Patond K. Long-term results of endoscopic lumbar discectomy by “Destandau's technique”. Asian Spine J 2016; 10 (02) 289-297