Lumbar disc reherniation after transforaminal lumbar endoscopic discectomy.
Ann Transl Med. 2018 Mar;6(6):106
Authors: Kosztowski TA, Choi D, Fridley J, Galgano M, Gokaslan Z, Oyelese A, Telfeian AE
Background: Transforaminal lumbar endoscopic discectomy is a minimally invasive surgical process that may be carried out in awake sufferers via an incision lower than 1 cm. The process requires little or no bony removing to entry the herniated disc materials as a result of the method is thru the foramen, and solely a small quantity of the superior articulating course of is eliminated to entry Kambin’s triangle. This examine describes our expertise with transforaminal endoscopic lumbar decompression (TELD) for the therapy of lumbar disc herniation. We consider the chance for reherniation within the first 12 months after surgical procedure and the traits of the sufferers who expertise reherniation.
Strategies: We describe the method for the transforaminal endoscopic method to deal with lumbar disc herniations. Retrospectively, a collection of 141 consecutive sufferers, who had been operated on with lumbar radiculopathy, was analyzed. We excluded sufferers who had earlier surgical procedure on the lumbar degree, surgical procedures executed for illness adjoining to a fusion, and surgical procedures executed for spondylolisthesis. A complete of 84 consecutive sufferers had been included who had single degree lumbar non-revision surgical procedure and at the least 1-year comply with up.
Outcomes: A collection of 46 consecutive male and 38 feminine sufferers with a median age of 57.four years (vary, 28-87 years previous) who underwent transforaminal endoscopic therapy for lumbar disc herniations between 2014 and 2016 is offered. 4 sufferers required microdiscectomy resulting from reherniation at 5 months, eight months, 9 months, and 10 months postoperatively. All of the sufferers within the collection improved instantly following their endoscopic procedures, and no sufferers offered with signs suggestive of reherniation till 5 months after their preliminary endoscopic surgical procedure. Sufferers with reherniation tended to be younger: 31, 45, 48, and 49 years of age: all lower than the common affected person age who underwent endoscopic surgical procedure.
Conclusions: Transforaminal endoscopic surgical entry to lumbar disc herniations is an ultra-minimally invasive method for the therapy lumbar degenerative disc illness. It permits for neural decompression by eradicating disc and foraminal pathology with minimal bone removing. This minimal bone removing prevents iatrogenic destabilization. Nonetheless, the 1-year reherniation fee offered right here is four.7%. This implies that the advantage of this system could also be that it’s ultra-minimally invasive, however it could solely be equal, not superior to microdiscectomy in its fee of reherniation.
PMID: 29707555 [PubMed]