Percutaneous Endoscopic Interlaminar Unilateral Ventral Dural Strategy for Symptomatic Bilateral L5-S1 Herniated Nucleus Pulposus: Technical Be aware.
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 remedy modality for lumbar disk herniation. Nonetheless, when a affected person complains of bilateral decrease limb radicular ache with extreme disk protrusion on the L5-S1 stage, the transforaminal method is commonly unable to resolve each lesions owing to anatomical limitations. It’s also very tough to resolve each lesions in an ipsilateral path utilizing the percutaneous interlaminar method. We report our surgical approach and scientific outcomes utilizing a ventral dural method of percutaneous endoscopic interlaminar lumbar diskectomy for L5-S1 herniated nucleus pulposus (HNP) in sufferers with bilateral radiculopathy on account of a extreme disk protrusion.
METHODS: ?Twenty-seven sufferers with extreme L5-S1 HNP complaining of again ache and bilateral decrease limb ache have been included within the examine. The unilateral ventral dural method of percutaneous full endoscopic interlaminar lumbar diskectomy approach was used. The visible analog scale (VAS) and Macnab standards have been used for scientific analysis. All assessments have been accomplished 1 day earlier than surgical procedure, 1?week after surgical procedure, 6 months after surgical procedure, and at last 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 last follow-up after surgical procedure. With respect to the Macnab standards, 51.85% of the outcomes have been glorious, 44.44% have been good, and three.70% have been honest. 4 circumstances recurred: three sufferers underwent conservative remedy and one affected person operated with percutaneous endoscopic interlaminar lumbar diskectomy.
CONCLUSION: ?In response to the outcomes of this examine, the ventral dural method of percutaneous full endoscopic interlaminar lumbar diskectomy in sufferers with L5-S1 HNP related to bilateral decrease limb ache on account of a severely protruded HNP is an effective possibility for a minimally invasive surgical method.
PMID: 29684923 [PubMed – as supplied by publisher]