Clinical effects of transforaminal and interlaminar percutaneous endoscopic discectomy for lumbar disc herniation

Abstract

The aim of this study is to observe the therapeutic effect of percutaneous endoscopic discectomy and its influencing factors for lumbar disc herniation and compare the advantages and disadvantages of transforaminal and interlaminar of percutaneous endoscopy.Data from 143 patients with lumbar disc herniation were respectively collected, including demographic and clinical data. Study population were divided into curative effect group and poor curative effect group, and logistic regression was used to explore the influencing factors of curative effect. The operation data and pre-and post-operation scores were compared to explore the effect of transforaminal and interlaminar approach on surgery efficacy.The rate of curative effect was 93.7%. 120 patients were classified as curative group and 23 patients were categorized as poor effective group. Univariate analysis found that the patients in the curative effect group tended to receive the interlaminar approach (58.3% vs 34.8%, P = .038). Multivariate logistic regression did not find operation approach was not related to curative effect of operation (transforaminal and interlaminar). But age ≥45 (odd risk (OR) = 6.43, P = .016), course of disease >12 month (OR = 3.77, P = .003), back and leg pain (OR = 3.46, P = .026), history of trauma (OR = 3.88, P = .014), Pfirrmann level IV (OR = 4.84, P = .004), and pre-Visual Analogue Scale (VAS) <5.3 (OR = 3.63, P = .015) were associated with operation efficacy. Compared with transforaminal group, the interlaminar group has less operative time (P = .000), less fluoroscopy time (P = .000), less puncture time (P = .000), less blood loss (P = .011).The transforaminal or interlaminar did not affect the treatment efficacy of percutaneous endoscopic discectomy for lumbar disc herniation. The selection of surgery approach depended on anatomical structure and physiological characteristics. It should be noted that 45 years of age or older, in the course of more than 12 months, both lumbocrural pain and lumbar disc herniation with grade IV, with history of trauma, may have impact on the efficacy of surgery.

Surgical outcomes of full endoscopic spinal surgery for lumbar disc herniation over a 10-year period: A retrospective study

“…Previous research has shown that the preoperative status of some patients was a potential risk factor for poor outcome or recurrence [ 8 , 15 – 18 , 23 ]. Older age has been shown to be a risk factor for poor outcome or recurrence in many studies [ 7 , 15 , 18 , 23 , 28 ]. In the present study, older age was significantly associated with poorer surgical outcome but not with recurrence rate in univariable study.…”

“…Many studies have proven its benefits, including less blood loss, less wound pain, and shorter recovery time [2][3][4][5][6]. However, large studies discussing potential factors associated with poor surgical outcomes were few [7][8][9][10][11][12]. Some studies have identified factors, such as herniation type, patient comorbidity, and age, as potential causes of surgical failure or unfavorable outcomes in traditional open or microscopic surgery, but few studies have investigated factors of FELD associating poor outcomes [8,[13][14][15][16][17][18][19].…”

Estimation and influence of blood loss under endoscope for percutaneous endoscopic lumbar discectomy (PELD): a clinical observational study combined with in vitro experiment

“…According to the approach, the percutaneous endoscopic lumbar discectomy is divided into the posterior approach and the lateral posterior approach [9,10], whereas the lateral posterior approach is divided into the Yeung endoscopic spine system (YESS) [11] and the transforaminal endoscopic spine system (TESSYS) [12,13]. Depending on the segment of disk herniation, the type of disk herniation, and individual surgical habits, the surgeon may perform the endoscopic surgery with different approaches [9,[14][15][16].…”

Comparison of percutaneous endoscopic discectomy and microendoscopic discectomy in treatment of symptomatic lumbar disc herniation

“…Nevertheless, in MD, it is inevitable that the laminabony structure and the spine tension band will be destroyed, which may cause low back pain and lumbar instability after operation. [ 11 – 15 ] In the past few years, the percutaneous endoscopic discectomy (PED) has increasingly become a common treatment for the symptomatic lumbar disc herniation. In numerous former reports, it possesses a good therapeutic effect on lumbar disc herniation.…”