Full endoscopic contralateral transforaminal discectomy for distally migrated lumbar disc herniation

Yeom, Kyeong-seong; Kim, Choong-Young

doi:10.1007/s00776-011-0048-0

Cited by 52 publications

(39 citation statements)

References 22 publications

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“…In this trial, only patients with non-sequestered herniations are included. Distally migrated discs are amenable to transforaminal surgery [24] but it is technically difficult. Inclusion of these patients was thought at the trial outset to potentially introduce bias.…”

Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of transforaminal endoscopic discectomy vs microdiscectomy

2016

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Purpose Transforaminal endoscopic discectomy (TED) minimises paraspinal muscle damage. The aim of this trial was to compare clinical outcomes of TED to Microdiscectomy (Micro). Methods 143 patients, age 25-70 years and \115 kg, with single level lumbar prolapse and radiculopathy, were recruited and randomised. 70 received TED under conscious sedation and 70 Micro under general anaesthesia. Oswestry Disability Index (ODI), visual analogue scores (VAS) of back and leg pain, and Short Form Health Survey indices (SF-36) were measured preoperatively and at 3, 12 and 24 months. Results All outcome measures improved significantly in both groups (p \ 0.001). Affected side leg pain was lower in the TED group at 2 years (1.9 ± 2.6 vs 3.5 ± 3.1, p = 0.002). Hospital stay was shorter following TED (0.7 ± 0.7 vs 1.4 ± 1.3 days, p \ 0.001). Two Micro patients and five TED patients required revision giving a relative risk of revision for TED of 2.62 (95% CI 0.49-14.0). Conclusions Functional improvements were maintained at 2 years in both groups with less ongoing sciatica after TED. A greater revision rate after TED was offset by a more rapid recovery.

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Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of transforaminal endoscopic discectomy vs microdiscectomy

2016

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“…Also, there is no interference with the epidural venous system that may lead to chronic neural edema and fibrosis. [7,18,19] Percutaneous endoscopic transforaminal lumbar discectomy is a minimally invasive procedure that preserves the stabilizing elements of the spine and avoids epidural scar formation. [6,20] In this study, the displacement values measured under loading after PTED and on the intact spine were similar to each other.…”

Section: (A) (B) (D) (C)mentioning

confidence: 99%

Biomechanical comparison of intact lumbar lamb spine and endoscopic discectomized lamb spine

Karakaşlı

Yıldız

Kumtepe

et al. 2013

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada minimal invaziv perkütan endoskopik diskektomi sonrası omurganın hareketli segmentinin biyomekanik değişiklikleri sağlam omurga ile karşılaştırıldı ve endoskopik diskektominin lomber kuzu omurgası üzerindeki etkileri araştırıldı. Gereç ve yöntemler: Bu çalışmada 10 adet taze donmuş kuzu omurgası kullanıldı. Her bir omurgaya L4-L5 seviyesinde perkütan endoskopik diskektomi yapıldı. Sağlam ve endoskopik diskektomi yapılmış omurgalar için biyomekanik test, aksiyel kompresyon test makinesi kullanılarak gerçekleştiril-di. Aksiyel kompresyon tüm örneklere 5 mm/dk yükleme hızı ile uygulandı. Her bir omurgaya, özel tasarlanmış bir aparatla, 8400 N/mm moment fleksiyon, ekstansiyon, sağa eğilme ve sola eğilme hareketlerinde uygulandı. Bulgular: Aksiyel kompresyon ve fleksiyon testlerinde yer değiştirme bulgularına göre örnekler daha stabildi. Diskektomi yapılmış omurgaların yer değiştirme değerleri, sağlam omurgaların değerlerine yakındı. Her iki grup karşı-laştırıldığında, sadece sola eğilme ön-arka kayma değerleri anlamlı idi (p≤0.05). Sonuç: Perkütan transforaminal endoskopik diskektominin, (PTED) biyomekanik ve klinik açıdan dezavantajı yoktur. Endoskopik diskektominin stabilite yönünden de herhangi bir dezavantajı yoktur. Yalnızca sola eğilmede öne arkaya kayma değerleri istatistiksel olarak anlamlı bulundu. Bu sonuçların nedenini tüm omurgaların sol taraftan PTED yapılmış olmasına bağlamaktayız.Anahtar sözcükler: Biyomekanik; endoskopik diskektomi; sağlam omurga.Objectives: This study aims to perform a biomechanical comparison of changes on motion segments after minimally invasive percutaneous endoscopically discectomized and intact spine and to investigate the effects of endoscopic discectomy on the lumbar spine of the lamb. Materials and methods: Ten fresh-frozen lamb spines were used in this study. Percutaneous endoscopic discectomy was performed on each spine at L4-L5 level. The biomechanical tests for both intact spine and endoscopically discectomized spine were performed by using axial compression testing machine. The axial compression was applied to all specimens with a loading speed of 5 mm/min. 8400 N/mm moment was applied to each specimen to achieve flexion and extension motions, right and left bending through a specially designed fixture. Results: In axial compression and flexion tests, the specimens were more stable based on displacement values. The displacement values of discected spines were closer to the values of intact specimens. Comparing both groups, only displacement values of the left-bending anteroposterior test were significant (p≤0.05). Conclusion: Percutaneous transforaminal endoscopic discectomy (PTED) has no biomechanical and clinical disadvantages. Endoscopic discectomy has also no stability disadvantages. Only anteroposterior displacement values of left bending test were statistically significant. We consider that the reason for such results were due to the fact that PTED was performed on the left side of all specimens.

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“…1,5,7,18,19 Other studies have shown that endoscopic spine surgery is an effective procedure for treating multiple pathologies in the lumbar spine, including lateral, paracentral, central, extruded, and even contralateral herniated discs, as well as lateral recess stenosis. 3,13,17,20 The success of treating lumbar radicular symptoms in the setting of spinal instrumentation has also recently been published. [14][15][16] Herein, we describe the first published case of a transforaminal endoscopic procedure used to successfully treat the complication of a vertebral body fracture after lumbar TDR, resulting in symptomatic foraminal compromise.…”

Section: Discussionmentioning

confidence: 99%

Transforaminal endoscopic decompression of a postoperative dislocated bone fragment after a 2-level lumbar total disc replacement: case report

Wagner

Iprenburg²,

Telfeian

2016

FOC

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The proposed advantages of total disc replacement (TDR) over fusion in the lumbar spine are the preservation of motion and the avoidance of adjacent-level disease. One of the complications inherent in TDR is the possibility of vertebral body fracture due to trauma or a malpositioned implant. The resulting dilemma is that posterior decompression of the displaced bone fragment could then have a destabilizing effect and possibly require fusion, thus obviating the benefit of an arthroplasty procedure. In this study, the authors describe the technical considerations and feasibility of the treatment of a postoperative L-5 paresis that resulted from a dislocated bone fragment at L4–5 during a 2-level lumbar TDR.

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Full endoscopic contralateral transforaminal discectomy for distally migrated lumbar disc herniation

Cited by 52 publications

References 22 publications

A randomised controlled trial of transforaminal endoscopic discectomy vs microdiscectomy

A randomised controlled trial of transforaminal endoscopic discectomy vs microdiscectomy

Biomechanical comparison of intact lumbar lamb spine and endoscopic discectomized lamb spine

Transforaminal endoscopic decompression of a postoperative dislocated bone fragment after a 2-level lumbar total disc replacement: case report

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