Analysis of curative effect: percutaneous transforaminal endoscopic discectomy for lumbar disc herniation with buttock pain as the main symptom

Abstract

Background . Lumbar disc herniation (LDH) is a common disease in spinal surgery which often causes acute radicular pain. However, LDH with buttock pain (BP) as the main clinical symptom is rare. Herein, we retrospectively evaluated the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of LDH with the buttock as the primary clinical symptom. Methods . Totally 12 patients have LDH (L4-5) with BP who underwent PTED from January 2019 to June 2020 were enrolled. All patients performed magnetic resonance imaging (MRI) and computed tomography (CT) preoperatively, 1 week postoperatively, and at follow-up. The pain relieve were evaluated by the Visual analog scale (VAS), the functional recovery was assessed by Oswestry disability index (ODI) and Roland-Morris questionnaire (RMQ). Parameters were evaluated preoperatively, immediately after surgery, 1 month, 3 months and 6 months after surgery, respectively. Moreover, the lumbar function was determined by modified MacNab criteria. Results . Pain relieve was found in 11 patients postoperatively. The VAS, ODI and RMQ scores were improved significantly at the latest follow up visit compared to preoperative (P < 0.05). One patient suffered from LDH recurrence one month after operation and received revision surgery, then achieved satisfied effect. Two patients experienced residual BP after operation and obtained good clinical outcomes by conservative treatment. No other surgical complications were found during follow up period. The average length of follow-up was 6.68 ± 0.67 months. Conclusion. PTED is a safe and efficacious method in treating LDH with BP.

An evidence‐based guideline on treating lumbar disc herniation with traditional Chinese medicine

“…The combination therapy performed better in terms of pain VAS scores 64,65 (MD = −1.56 scores, 95% CI: −2.13 to −1.00; low quality), ODI scores 65 (MD = −5.66 scores, 95% CI: −6.88 to −4.44; low quality), and inflammation level 64,65 (TNF-α and IL-1β). Included studies did not report adverse reactions related to Osteoking in combination with usual western medical therapy.…”

“…Two RCTs 64,65 compared Osteoking in combination with usual western medical therapy versus usual western medical therapy for LDH.…”