Comparative Study between Full-Endoscopic Discectomy and Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

Fujita, Muneyoshi; Kitagawa, Toshiki; Hirahata, Masahiro; Inui, Takahiro; Kawano, Hirotaka; Iwai, Hiroki; Inanami, Hirohiko; Koga, Hisashi

doi:10.3390/medicina56120710

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…However, with the decrease in the height of the intervertebral disc, the anterior and posterior longitudinal ligaments of the intervertebral disc become relaxed, and the range of motion of the lumbar spine increases, which may lead to adhesions and hyperplasia of the small joints, thus affecting the stability of the lumbar spine [ 23 ]. In the long term, decreased intradiscal pressure and increased facet loading after the loss of DH after discectomy have the potential to have adverse effects on the stability of the spine, increasing postoperative pain scores[ 24 ]. However, there are also some shortcomings in this study, as the maximum follow-up time of the studies we included was 2.3 years and no long-term follow-up was studied, so there are still some limitations to the correlation between lower back pain (VAS) and intervertebral disc height values.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Pain Scores and Disc Height Changes after Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Zheng

Lan

Chen

et al. 2022

Computational Intelligence and Neuroscience

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Background. Surgery can reduce and improve lumbar disc herniation, but some patients still have pain after surgery, and the relationship between lumbar disc height and pain after surgery is still unclear. Objective. The main objective is to investigate the relationship between lumbar disc height and postoperative pain. Methods. We searched Pubmed, Web of Science, the Cochrane library, and Embase online for cohort studies or RCT studies on discectomy and assessed the quality of the included articles using the Newcastle-Ottawa Scale (NOS scale), with disc height (DH) and postoperative back pain as the main clinical outcome indicators, and the correlation coefficient between DH and back pain as the statistic to assess the pooled effect size. Results. 10 kinds of literature were included in this study for quantitative analysis. A total of 589 patients participated in the study. The follow-up time was between 1 and 2.3 years. Meta-analysis showed that after surgery, the relief of back pain was statistically significant (MD = −2.57, 95% CI (−3.10,−2.04), Z = −9.570, P < 0.0001 ), the reduction of disc height was statistically significant (MD = −0.82, 95% CI (−1.11, −0.52), Z = −5.477, P < 0.0001 ), the combined value of correlation coefficient Fisher’s Z value was 0.33, 95% CI (0.25,0.42), with statistical significance ( P < 0.00001 ), suggesting that the degree of back pain after surgery showed a moderate positive correlation with disc height in the short term. Discussion. After discectomy, the degree of pain is relieved, the disc height is reduced, and low back pain in the short term and disc height showed a moderate positive correlation, but the long-term correlation remains to be studied in depth.

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Section: Discussionmentioning

confidence: 99%

Correlation between Pain Scores and Disc Height Changes after Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Zheng

Lan

Chen

et al. 2022

Computational Intelligence and Neuroscience

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“…These findings are in line with those of previous studies. 23 - 25 Although not statistically significant, FED might prevent complications such as dural tears and hematoma. More than 100 mL of intraoperative bleeding was observed in 9 MED cases, and hemostasis was observed; however, we did experience such bleedings in only 1 FED.…”

Section: Discussionmentioning

confidence: 90%

Comparison of the Outcomes of Microendoscopic Discectomy Versus Full-Endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation

Fujita

Inui

Oshima

et al. 2022

Global Spine Journal

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Study Design Retrospective Comparative Study. Objectives To compare the outcomes of microendoscopic discectomy (MED) versus full-endoscopic discectomy (FED) for treating L4/5 lumbar disc herniation (LDH). Methods A retrospective study was performed on patients with L4/5 LDH treated using MED (n = 249) or FED (n = 124). A 16-mm tubular retractor and endoscope was used for MED, while a 4.1-mm working channel endoscope was used for FED. Patient background and operative data were collected. The Oswestry Disability Index (ODI) and European Quality of Life-5 Dimensions (EQ-5D) scores were recorded preoperatively and at 1 and 2 years postsurgery. Results The background data of the two groups were similar. The mean operation times for MED and FED were 59.3 and 47.7 min (respectively), and the mean volumes of removed nucleus pulposus were .65 and 1.03 g, respectively. These differences were significant ( P < .001). Six dural tears and one postoperative hematoma were observed in the MED group; none were observed in the FED group. During the follow-up period, 16 MED and 7 FED patients required re-operation due to recurrence ( P = 1.00). Although the ODI and EQ-5D scores significantly improved at 1 and 2 years postsurgery in both groups, the differences were not statistically significant. Conclusions Operative outcomes were almost identical in both groups. We did not observe any operative or postoperative complications in FED. We, therefore, recommend FED as the first option for the treatment of L4/5 LDH since it has a better safety profile and is minimally invasive.

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“…Regarding this phenomenon, certain studies have indicated that the reduction in disc height is frequently accompanied by alterations such as diminished pressure within the disc and heightened stress on the adjacent joints due to dehydration. Consequently, this results in increases in postoperative pain 24 . Wang et al .…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, this results in increases in postoperative pain. 24 Wang et al revealed that the collapse of disc height after transforaminal endoscopic lumbar discectomy was linked to short-and long-term postoperative low back pain in a multicenter study. 25 Yet there are some different views.…”

Section: Clinical Efficacy and Parameter Variation Are Observed At Th...mentioning

confidence: 99%

Correlation between Disc Imaging Observations and Clinical Efficacy after Percutaneous Endoscopic Lumbar Discectomy: A 1‐Year Follow‐up Study

Li,

Wang,

Huang

et al. 2024

Orthopaedic Surgery

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ObjectiveThe connection between alterations in the disc structure following percutaneous endoscopic lumbar discectomy (PELD) and symptoms in patients postsurgery has not been reported yet. The purpose of the present study was to discuss the potential correlation between the changes in the morphological characteristics of various reference surfaces of the intervertebral disc after percutaneous endoscopic lumbar discectomy (PELD) and clinical outcomes, to identify the morphological parameters that affect efficacy and provide an evidence‐based foundation for assessing postoperative efficacy.MethodsFrom October 2019 to October 2021, after percutaneous endoscopic lumbar discectomy (PELD), 98 individuals were enrolled. MRI DICOM data of the lumbar spine were obtained before and after surgery, specifically around 3 months. The morphological parameters of the operated and adjacent segments of the discs were measured using T2‐weighted images from three reference planes. Outcomes were assessed using the Oswestry disability index (ODI), visual analogue pain scores for the back and leg (VAS‐back/VAS‐leg), Japanese Orthopaedic Association (JOA) scores, and recovery rates. Postoperative changes in disc parameters and outcomes were compared between patients with different severity and types of LDH based on the MSU staging. Patients completed the questionnaire during outpatient follow‐up appointments 3, 6, and 12 months after the surgery. The follow‐up period was 14.69 ± 4.21 months, ranging from 12 to 24 months.ResultsParameters such as area and circumference of intervertebral discs in the cross‐section were not associated with the change in the efficacy index. Postoperatively, a negative correlation between the variation of the disc height, disc height index, and protrusion distance and the difference in VAS scores for low back pain at 3 and 6 months was observed among the two sagittal change parameters. Differences between changes in disc imaging parameters and postoperative efficacy were not statistically significant between various types of lumbar disc herniation.ConclusionFor the patients after percutaneous endoscopic lumbar discectomy, the changes in parameters such as disc area and circumference in the cross‐sectional plane are not associated with efficacy, and the changes in disc height and herniation distance in the sagittal plane provide a morphologic basis for the assessment of short‐term postoperative efficacy. In addition, the changes in disc morphologic parameters and postoperative efficacy do not differ between various types of lumbar disc herniation.

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Comparative Study between Full-Endoscopic Discectomy and Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation

Cited by 5 publications

References 26 publications

Correlation between Pain Scores and Disc Height Changes after Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Correlation between Pain Scores and Disc Height Changes after Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Comparison of the Outcomes of Microendoscopic Discectomy Versus Full-Endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation

Correlation between Disc Imaging Observations and Clinical Efficacy after Percutaneous Endoscopic Lumbar Discectomy: A 1‐Year Follow‐up Study

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