Clinical success of transforaminal endoscopic discectomy with foraminotomy: A retrospective evaluation

Jasper, Gabriele P.; Francisco, Gina; Telfeian, Albert E.

doi:10.1016/j.clineuro.2013.05.033

Cited by 56 publications

(44 citation statements)

References 8 publications

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“…The clinical efficacy of PELD has been confirmed by many studies (Hoogland et al, 2008;Nellensteijn et al, 2010;Jasper et al, 2013), but learning curve evaluation is essential in this regard (Benzel and Orr, 2011). To the best of our knowledge, this is the first study to compare the learning curves of PELD in a transforaminal approach at the L4/5 and L5/S1 levels.…”

Section: Discussionmentioning

confidence: 92%

Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study

Fan

et al. 2016

J. Zhejiang Univ. Sci. B

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Abstract:Objectives: This study aimed to compare the learning curves of percutaneous endoscopic lumbar discectomy (PELD) in a transforaminal approach at the L4/5 and L5/S1 levels. Methods: We retrospectively reviewed the first 60 cases at the L4/5 level (Group I) and the first 60 cases at the L5/S1 level (Group II) of PELD performed by one spine surgeon. The patients were divided into subgroups A, B, and C (Group I: A cases 1-20, B cases 21-40, C cases 41-60; Group II: A cases 1-20, B cases 21-40, C cases 41-60). Operation time was thoroughly analyzed. Results: Compared with the L4/5 level, the learning curve of transforaminal PELD at the L5/S1 level was flatter. The mean operation times of Groups IA, IB, and IC were (88.75±17.02), (67.75±6.16), and (64.85±7.82) min, respectively. There was a significant difference between Groups A and B (P<0.05), but no significant difference between Groups B and C (P=0.20). The mean operation times of Groups IIA, IIB, and IIC were (117.25±13.62), (109.50±11.20), and (92.15±11.94) min, respectively. There was no significant difference between Groups A and B (P=0.06), but there was a significant difference between Groups B and C (P<0.05). There were 6 cases of postoperative dysesthesia (POD) in Group I and 2 cases in Group IIA (P=0.27). There were 2 cases of residual disc in Group I, and 4 cases in Group II (P=0.67). There were 3 cases of recurrence in Group I, and 2 cases in Group II (P>0.05). Conclusions: Compared with the L5/S1 level, the learning curve of PELD in a transforaminal approach at the L4/5 level was steeper, suggesting that the L4/5 level might be easier to master after short-term professional training.

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Section: Discussionmentioning

confidence: 92%

Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study

Fan

et al. 2016

J. Zhejiang Univ. Sci. B

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“…Recent non-randomized lumbar studies include a single surgeon evaluation of 400 patients using the translaminar approach for lumbar disc herniations, a study of 300 central and foraminal degenerative spinal stenosis who underwent posterior endoscopic decompression, 4 50 geriatric patients aged 75 years and older who underwent transforaminal foraminal decompression, and a review of 611 patients and associated complications. 4,25,35 Additional studies include the use of endoscopic techniques in the treatment of spinal infections, thoracic as well as cervical disc herniations 3,5,20 Recent articles have also explored more advanced indications for endoscopic surgical techniques including single level multi-focal disc excision and foraminal decompression for primary foraminal stenosis as well as failed back syndrome.…”

Section: Discussionmentioning

confidence: 99%

Full Endoscopic Spinal Surgery Techniques: Advancements, Indications, and Outcomes

Yue

2015

Int J Spine Surg

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Advancements in both surgical instrumentation and full endoscopic spine techniques have resulted in positive clinical outcomes in the treatment of cervical, thoracic, and lumbar spine pathologies. Endoscopic techniques impart minimal approach related disruption of non-pathologic spinal anatomy and function while concurrently maximizing functional visualization and correction of pathological tissues. An advanced understanding of the applicable functional neuroanatomy, in particular the neuroforamen, is essential for successful outcomes. Additionally, an understanding of the varying types of disc prolapse pathology in relation to the neuroforamen will result in more optimal surgical outcomes. Indications for lumbar endoscopic spine surgery include disc herniations, spinal stenosis, infections, medial branch rhizotomy, and interbody fusion. Limitations are based on both non spine and spine related findings. A high riding iliac wing, a more posteriorly located retroperitoneal cavity, an overly distal or proximally migrated herniated disc are all relative contra-indications to lumbar endoscopic spinal surgery techniques.Modifications in scope size and visual field of view angulation have enabled both anterior and posterior cervical decompression. Endoscopic burrs, electrocautery, and focused laser technology allow for the least invasive spinal surgical techniques in all age groups and across varying body habitus. Complications include among others, dural tears, dysesthsia, nerve injury, and infection.

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“…Although it's not mentioned here, applications of endoscopic techniques are gradually increasing to other lumbar diseases, such as instability, [41] [42] multi levels surgery, [43] recurrent discs [44], and spinal stenosis [45] [46].…”

Section: Discussionmentioning

confidence: 99%

The Clinical Outcomes of Transforaminal Percutaneous Endoscopic Discectomy in Treating Lumbar Disc Herniation: A Review

Rakesh¹,

Wang²

2018

OJO

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Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive technique started during the late 20 th century. This process is done through microscopic view under local anesthesia. There is a growing but still insufficient evidence that lumbar EDS shows slightly better results in terms of minor tissue damage, shorter hospital stay, faster return to ordinary daily activities, and patient satisfaction. Recurrence rate still remains a matter of debate, and is related with the surgical skills of the surgeon. The complication rate seems to be similar in both of the techniques i.e., open and endoscopic. More randomized controlled trials, systematic reviews and meta-analysis are needed to clarify whether lumbar EDS can be considered comparable if not superior to standard open discectomy. In spite of lacking defined clinical evidence, lumbar EDS is without doubt a rapidly expanding PELD and its future developments are incredibly promising. Due to less complication rate this technique can be considered as a gold standard compared to the open discectomy. The surgeons still require more cadaveric practices for learning the curve and to approach the herniated disc area. The main objective of this review article is to show the clinical outcomes of the Transforaminal Percutaneous Endoscopic Discectomy in treating the lumbar disc herniation.

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Clinical success of transforaminal endoscopic discectomy with foraminotomy: A retrospective evaluation

Cited by 56 publications

References 8 publications

Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study

Learning curves of percutaneous endoscopic lumbar discectomy in transforaminal approach at the L4/5 and L5/S1 levels: a comparative study

Full Endoscopic Spinal Surgery Techniques: Advancements, Indications, and Outcomes

The Clinical Outcomes of Transforaminal Percutaneous Endoscopic Discectomy in Treating Lumbar Disc Herniation: A Review

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