Transforaminal Percutaneous Endoscopic Discectomy for Symptomatic Gas-filled Discal Cysts

Abstract

Objective The aim of this retrospective study is to review our experience in the diagnosis and role of transforaminal percutaneous endoscopic discectomy (TPED) for symptomatic gas-filled discal cysts. Methods Between May 2014 and June 2017, 3 patients from Lishui Center Hospital (Lishui China), who underwent TPED for symptomatic gas-filled discal cysts, were analyzed. The clinical features, imaging findings, operative findings and treatment outcomes are presented. In addition, relevant literature regarding gas-filled discal cysts were searched using PubMed, and their characteristics, clinical features, therapeutic strategies and survival outcomes were reviewed. Results The median age of the patients was 56.7 years (range, 55-60 years). In all patients, a discal cyst was located in the lumbar region, and the patients presented with backache and numbness in the lower extremities. The diagnosis was made by lumbar 3 dimensional-computed tomography (3D-CT) or magnetic resonance imaging (MRI). All patients underwent TPED. All patients recovered successfully and were eventually discharged. Eighteen articles were identified from the searches of the database, and a total of 41 patients were included. There were 32 males and 9 females. The mean age was 58.1 years, ranging from 27 to 85 years. Lower back pain was the major symptom. Twenty-four patients underwent surgery, 4 patients underwent percutaneous needle aspiration, and 2 patients underwent drug therapy.Conclusion TPED for gas-filled discal cysts is feasible, effective and successful, although it should be performed by an experienced surgeon with awareness of the potential risk of severe nerve root injury.