Percutaneous Endoscopic Lumbar Diskectomy for Axillar Herniation at L5-S1 via the Transforaminal Approach Versus the Interlaminar Approach: A Prospective Clinical Trial

Mo, Xiaoyi; Shen, Jieliang; Wei, Jue; Zhang, Xiaojun; Zhou, Nian; Wang, Yiyang; Hu, Zhenming; Hao, Jie

doi:10.1016/j.wneu.2019.01.114

Cited by 18 publications

(24 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical Outcome and Surgical Data According to the revolutionary advances in technology and instruments, PETD is used widely, and is an effective option for almost all types of disc herniation [23][24][25] According to the clinical outcome of PETD, Ren et al 24 reported that the VAS and ODI scores were improved significantly in patients with lumbar disc herniation causing bilateral symptoms. Yeung et al 27 stated that the VAS score was reduced significantly after treatment of symptomatic degenerative conditions using the inside-out transforaminal technique.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Comparison Between Retaining and Resecting the Posterior Longitudinal Ligament in Percutaneous Endoscopic Transforaminal Discectomy for Disc Herniation: A Retrospective Cohort Study

Liu

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective To compare the efficacy and safety of retaining the posterior longitudinal ligament (PLL) with resecting the PLL in inside‐out percutaneous endoscopic transforaminal discectomy (PETD) surgery for lumbar disc herniation (LDH). Method A total of 135 patients with symptomatic LDH who were treated by inside‐out PETD surgery from January 2015 to January 2017were included in this retrospective analysis. There were 38 males and 30 females in the PLL resection group (mean age = 52.40 ± 8.73 years) and 35 males and 32 females in the PLL retention group (mean age = 53.50 ± 9.24 years). The visual analogue scale (VAS) score, Oswestry disability index (ODI), and modified MacNab criteria were used to evaluate clinical outcomes. Operation time, blood loss, recurrence of LDH, and complications were recorded. Three months after surgery, magnetic resonance imaging was performed to confirm that nerve root compression was relieved. Results The VAS and ODI scores improved significantly immediately after surgery, at 1 month after surgery, at 3 months after surgery, and at last follow‐up compared with those before surgery (P < 0.01). The scores also improved significantly between immediately after surgery and 1 month after surgery in the two groups (P < 0.001). Multivariate analysis indicated that age ≥ 50 years (odds ratio (OR) = 6.33, 95% confidence interval (CI): 1.64–21.98, P = 0.014), pain duration ≥6 months (OR = 4.68, 95% CI: 1.29–6.51, P = 0.025), pre‐ODI score ≥ 40% (OR = 5.97, 95% CI: 2.41–14.86, P = 0.003) were all associated with poor functional outcomes. There was no significant difference in the excellent/good ratio between the two groups and the mean operation time of the retention group was 71.5% of that of the resection group (82.7 ± 18.5 min vs 115.6 ± 24.6 min, P < 0.01). In the patients, no serious complications, such as dural tear, wound infection, or persistent nerve root injury, were observed during the follow‐up period. There was no significant difference in the complication rate between the two groups (6/68 vs 6/67, P = 0.979). Although the recurrence rate was higher in retention group, there was no significant difference between the two groups (1/68 vs 2/67, P = 0.551). Conclusion The PLL is recommended to be retained for inside‐out PETD surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

“…According to the revolutionary advances in technology and instruments, PETD is used widely, and is an effective option for almost all types of disc herniation 23 , 24 , 25 . Theoretically, minimally invasive technology could shorten the operation time and reduce the blood loss compared with open lumbar decompression surgery.…”

Section: Discussionmentioning

confidence: 99%

A Comparison Between Retaining and Resecting the Posterior Longitudinal Ligament in Percutaneous Endoscopic Transforaminal Discectomy for Disc Herniation: A Retrospective Cohort Study

Liu

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…Percutaneous endoscopic interlaminar discectomy has been widely used in the management of L 5 –S 1 LDH, with the advantages including escaping the blockade of crista iliaca, a faster puncture orientation, decreased intraoperative blood loss, a shorter operation time, and less intraoperative radiation exposure 4–7 . Normally, PEID can be performed at L 5 S 1 level because the interlaminar window of L 5 S 1 is the largest 8 .…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous endoscopic therapy for disc herniation can be divided into the transforaminal approach 2 (percutaneous endoscopic transforaminal discectomy [PETD]) and the interlaminar approach 3 (percutaneous endoscopic interlaminar discectomy [PEID]). For L 5 S 1 level, PEID, which can escape the blockade of crista iliaca, has advantages over PETD, including reducing the difficulty of puncture, a faster puncture orientation, a shorter operation time, and less intraoperative radiation exposure 4–7 .…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Endoscopic Interlaminar Discectomy via Laminoplasty Technique for L₅–S₁ Lumbar Disc Herniation with a Narrow Interlaminar Window

Yuan

Jia

et al. 2021

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective To improve the treatment effect of patients with L5S1 lumber disc herniation (LDH) with a narrow interlaminar window, we proposed an alternative approach to percutaneous endoscopic interlaminar discectomy (PEID) via the laminoplasty technique. Methods Fifteen L5S1 LDH patients (7 men and 8 women; age range, 22 to 56 years; median age, 34 years; 9 left, 6 right) were enrolled in the present study retrospectively. The interlaminar windows of all patients were narrow (the transverse diameter of the L5S1 interlaminar window is equal to or less than that of L4–5). Percutaneous laminoplasty and endoscopic interlaminar discectomy surgery were undergone by all patients from July 2018 to July 2019. All operations were completed under local anesthesia. The target laminoplasty area was the safety zone, use of which avoids both transverse and exit nerve roots. Under fluoroscopic guidance or clear endoscopic visualization, the trephines were used to enlarge the interlaminar window, which allowed the working cannula to enter the spinal canal but avoid nerve roots and the dural sac. The preoperative/postoperative visual analogue scale (VAS) scores and Oswestry disability index (ODI) were statistically analyzed. The modified MacNab criterion was used to assess the clinical effects. The radiological outcomes were evaluated by MRI and CT. SPSS 19.0 software was used for the statistical evaluation. Results The operative time ranged from 70 to 120 min, with a median time of 92 min, and the fluoroscopy times ranged from 8 to 12, with a median of 9.7 times. The body mass index (BMI) of patients ranged from 18.10 to 26.06, with a median of 22.04. All patients were followed up in the outpatient department for at least 12 months after surgery. At the last follow up, the average VAS‐Back score of the study patients was reduced from 5.33 ± 2.09 to 2.00 ± 1.20 (P < 0.001) and the average VAS‐Leg score was reduced from 7.53 ± 1.69 to 1.47 ± 0.92 (P < 0.001). The average ODI scores improved from 47.87 ± 11.41 to 12.93 ± 3.24 (P < 0.01). According to the modified MacNab criteria, 11 cases achieved excellent results and 4 cases achieved good results. All of the operations were successful. There wertr no nerve root injuries, dural tears, or other complications. Conclusion The laminoplasty approach for PEID provides a safe and useful alternative for the treatment of L5–S1 LDH patients with a narrow interlaminar window.

show abstract

“…[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Five trials performed the comparison between PETD and PEID. [35][36][37][38][39] Among those trials comparing ED with NED, PELD was performed in 10 trials, 16,20,[22][23][24][25][26]31,33,34 FE in 4 trials 21,[28][29][30] and MED in 6 trials. 15,[17][18][19]27,32 The characteristics of the included trials were shown in Table 1 and Table 2.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Comparison of Endoscopic Discectomy Versus Non-Endoscopic Discectomy for Symptomatic Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Yan

Lin

2021

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Systematic review. Objective: The authors aimed to systematically compare the effectiveness and safety of endoscopic discectomy (ED) with non-endoscopic discectomy (NED) for treatment of symptomatic lumbar disc herniation (LDH). Methods: A systematic search was performed on PubMed, EMBASE, the Cochrane Library and China National Knowledge Infrastructure for randomized controlled trial from inception until August 13, 2020. Trials which investigated multiple operative approaches on lumbar disc herniation were identified without language restrictions. Results: In total, 25 trials involving 2258 patients with symptomatic LDH were included. Twenty trials performed the comparison between ED and NED. Five trials performed the comparison between percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID). The operative time of micro-endoscopic discectomy (MED) was longer than open discectomy (OD). The length of hospital stay of percutaneous endoscopic lumbar discectomy (PELD) was shorter than fenestration discectomy (FD). Significant differences in intraoperative blood loss volumes were found between PELD with FD and MED with OD. The complication rate of PELD was lower than FD (PELD: 4.3%; FD: 14.6%) and the complication rate of full-endoscopic discectomy (FE) was lower than microscopic discectomy (MD) (FE: 13.4%; MD: 32.1%). Conclusions: PELD and FE have the advantage of limiting intraoperative damages. ED and NED can be both considered sufficient to achieve good clinical outcomes. PETD and PEID are able to achieve similar results but the learning curve of PETD was steeper. More independent high-quality RCTs with sufficiently large sample sizes performing cost-effectiveness analyzes are needed.

show abstract

Percutaneous Endoscopic Lumbar Diskectomy for Axillar Herniation at L5-S1 via the Transforaminal Approach Versus the Interlaminar Approach: A Prospective Clinical Trial

Cited by 18 publications

References 21 publications

A Comparison Between Retaining and Resecting the Posterior Longitudinal Ligament in Percutaneous Endoscopic Transforaminal Discectomy for Disc Herniation: A Retrospective Cohort Study

A Comparison Between Retaining and Resecting the Posterior Longitudinal Ligament in Percutaneous Endoscopic Transforaminal Discectomy for Disc Herniation: A Retrospective Cohort Study

Percutaneous Endoscopic Interlaminar Discectomy via Laminoplasty Technique for L₅–S₁ Lumbar Disc Herniation with a Narrow Interlaminar Window

Comparison of Endoscopic Discectomy Versus Non-Endoscopic Discectomy for Symptomatic Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About

Percutaneous Endoscopic Lumbar Diskectomy for Axillar Herniation at L5-S1 via the Transforaminal Approach Versus the Interlaminar Approach: A Prospective Clinical Trial

Cited by 18 publications

References 21 publications

A Comparison Between Retaining and Resecting the Posterior Longitudinal Ligament in Percutaneous Endoscopic Transforaminal Discectomy for Disc Herniation: A Retrospective Cohort Study

A Comparison Between Retaining and Resecting the Posterior Longitudinal Ligament in Percutaneous Endoscopic Transforaminal Discectomy for Disc Herniation: A Retrospective Cohort Study

Percutaneous Endoscopic Interlaminar Discectomy via Laminoplasty Technique for L5–S1 Lumbar Disc Herniation with a Narrow Interlaminar Window

Comparison of Endoscopic Discectomy Versus Non-Endoscopic Discectomy for Symptomatic Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About

Percutaneous Endoscopic Interlaminar Discectomy via Laminoplasty Technique for L₅–S₁ Lumbar Disc Herniation with a Narrow Interlaminar Window