Percutaneous Endoscopic Interlaminar Unilateral Ventral Dural Strategy for Symptomatic Bilateral L5-S1 Herniated Nucleus Pulposus: Technical Notice.
J Neurol Surg A Cent Eur Neurosurg. 2018 Apr 23;:
Authors: Choi SH, Adsul NM, Kim HS, Kim KJ, Kim JH, Chung SK, Choi JH, Jang JS, Jang IT, Oh SH
BACKGROUND: ?Percutaneous endoscopic lumbar diskectomy is an effective therapy modality for lumbar disk herniation. Nevertheless, when a affected person complains of bilateral decrease limb radicular ache with extreme disk protrusion on the L5-S1 degree, the transforaminal method is usually unable to resolve each lesions owing to anatomical limitations. Additionally it is very troublesome to resolve each lesions in an ipsilateral route utilizing the percutaneous interlaminar method. We report our surgical approach and medical outcomes utilizing a ventral dural method of percutaneous endoscopic interlaminar lumbar diskectomy for L5-S1 herniated nucleus pulposus (HNP) in sufferers with bilateral radiculopathy as a consequence of a extreme disk protrusion.
METHODS: ?Twenty-seven sufferers with extreme L5-S1 HNP complaining of again ache and bilateral decrease limb ache had been included within the research. The unilateral ventral dural method of percutaneous full endoscopic interlaminar lumbar diskectomy approach was used. The visible analog scale (VAS) and Macnab standards had been used for medical analysis. All assessments had been accomplished 1 day earlier than surgical procedure, 1?week after surgical procedure, 6 months after surgical procedure, and at closing follow-up after surgical procedure.
RESULTS: ?The imply preoperative again and leg ache VAS scores decreased from 5.67?±?zero.78 and seven.81?±?zero.83 to 2.44?±?zero.58 and a pair of.26?±?zero.53 at 1?week, 1.78?±?zero.51 and 1.52?±?zero.58 at 6 months, and 1.56?±?zero.70 and 1.67?±?zero.96, respectively, on the closing follow-up after surgical procedure. With respect to the Macnab standards, 51.85% of the outcomes had been wonderful, 44.44% had been good, and three.70% had been truthful. 4 circumstances recurred: three sufferers underwent conservative therapy and one affected person operated with percutaneous endoscopic interlaminar lumbar diskectomy.
CONCLUSION: ?In accordance with the outcomes of this research, the ventral dural method of percutaneous full endoscopic interlaminar lumbar diskectomy in sufferers with L5-S1 HNP related to bilateral decrease limb ache as a consequence of a severely protruded HNP is an effective choice for a minimally invasive surgical method.
PMID: 29684923 [PubMed – as supplied by publisher]