Transforaminal percutaneous endoscopic lumbar discectomy: outcome and complications in 270 cases

Tacconi, Leonello; Baldo, Sara; Merci, Giorgio; Serra, Gerardo

doi:10.23736/s0390-5616.18.04395-3

Cited by 19 publications

(15 citation statements)

References 14 publications

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“…Many previous studies have focused on the complications of PELD-based treatment of LDH [ 1 , 2 , 15 ]. However, few studies have reported complications and risks involved in the treatment of LSS with PELD.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous endoscopic transforaminal discectomy (PETD), which is a percutaneous endoscopic lumbar discectomy (PELD), has become a routinely performed minimally invasive spinal procedure for the treatment of lumbar disc herniation (LDH) [ 1 , 2 ]. However, with the advancements in surgical methods, optical designs, and surgical instruments, PETD has become the treatment option for lumbar spinal stenosis (LSS) in recent years [ 3 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, PETD has difficulty in dealing with cases of L5/S1 because of the obstruction of the iliac crest [ 11 ]. Previous studies have reported a variety of complications, such as recurrence of LDH (rLDH), incomplete decompression, nerve root injury, dural tear, visceral injury, nerve root induced hyperalgesia or burning-like nerve root pain, postoperative dysesthesia, intraoperative seizure, posterior neck pain, surgical site infection, and instrument breakage, in the treatment of LDH using PELD [ 1 , 2 , 12 – 14 ]. In addition, these complications are associated with multiple factors, including rLDH-related risk factors, such as obesity, old age, Modic changes, low grade of surgical-level disc degeneration, high disc height index (DHI), large sagittal range of motion, and severe grade of adjacent-level disc degeneration [ 15 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis

Fan

Yuan

et al. 2021

BMC Musculoskelet Disord

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Background With the advancements in surgical methods, optical designs, and surgical instruments, percutaneous endoscopic transforaminal discectomy (PETD) has become an effective and minimally invasive procedure to treat lumbar spinal stenosis (LSS) in recent years. Few studies have focused on the complications associated with the treatment of LSS using percutaneous endoscopic lumbar discectomy (PELD). This study aimed to summarize the complications of PETD and identify the associated risk factors. Methods Complications in a total of 738 consecutive LSS patients who underwent single-level PETD were retrospectively recorded and analyzed between January 2016 and July 2020. In addition, a matched case-control study was designed, and according to the date of operation, the control group was matched with patients without complications, with a matching ratio of 1:3. Demographic parameters included age, sex, BMI, smoking and drinking status, comorbidity, and surgical level. The radiological parameters included grade of surgical-level disc degeneration, number of degenerative lumbar discs, grade of lumbar spinal stenosis, degenerative lumbar scoliosis, lumbar lordosis, disc angle, and disc height index. Univariate analysis was performed using independent samples t-test and chi-squared test. Results The incidence of different types of complications was 9.76% (72/738). The complications and occurrence rates were as follows: recurrence of LSS (rLSS), 2.30% (17/738); persistent lumbosacral or lower extremity pain, 3.79% (28/738); dural tear, 1.90% (14/738); incomplete decompression, 0.81% (6/738); surgical site infection, 0.41% (3/738); epidural hematoma, 0.27% (2/738); and intraoperative posterior neck pain, 0.27% (2/738). Univariate analysis demonstrated that age, the grade of surgical-level disc degeneration (P < 0.001) and the number of disc degeneration levels (P = 0.004) were significantly related to the complications. Conclusion Complications in the treatment of LSS using PELD included rLSS, persistent pain of the lumbosacral or lower extremity, dural tear, incomplete decompression, surgical site infection, epidural hematoma, and intraoperative posterior neck pain. In addition, old age, severe grade of surgical-level disc degeneration and more disc degeneration levels significantly increased the incidence of complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis

Fan

Yuan

et al. 2021

BMC Musculoskelet Disord

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“…Therefore, the puncture needle is easy to slip into the patient's foramina after implantation, resulting in damage to the patient's dural sac and nerve root. As a result, during the actual clinical operation, doctors often need to perform multiple X-ray fluoroscopy the operation, which not only prolongs the operation time but also increases the radiation dose of patients (17,18). In the process of locating the facet, the tip of the dilator is applied to the dorsal side of the superior facet.…”

Section: Evaluation Of the Prognostic Efficacy Of Il-8 Crp And Txb2 I...mentioning

confidence: 99%

The effect of locating and sliding of facet combined with percutaneous endoscopic lumbar discectomy on cell inflammatory indicators and the treatment of disc herniation

Zhang

2022

Cell Mol Biol (Noisy-le-grand)

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This study aimed to investigate the effects of IL-8, CRP and TXB2 in the treatment of lumbar disc herniation by combining with percutaneous endoscopic discectomy. For this purpose, 290 patients with disc herniation were selected as the research objects and randomly divided into two groups. The control group was treated with traditional intervertebral fenestration of nucleus pulposus, and the research group was treated with joint process location slip technique combined with percutaneous endoscopic lumbar disc discectomy. The clinical efficacy, functional scores and serological indexes of the two groups were compared, and the prognostic value of IL-8, CRP and TXB2 in the treatment of disc herniation by the combination of the sliding technique of facet location and percutaneous endoscopic discectomy was explored. The results showed that the total effective rate of 95.55% in the study group was higher than 79.31% in the control group, and the difference was significant (P<0.05). The operative time, incision length, length of hospital stay and intraoperative blood loss in the study group were lower than those in the control group (P<0.05). JOA score was higher and ODI score was lower in the two groups after surgery than before surgery, and JOA score in the study group was higher than that in the control group, while the ODI score was lower than that in the control group (P<0.05). Il-8, CRP and MDA in 2 groups increased after the operation, while SOD and TXB2 decreased significantly. Il-8, CRP, TXB2 and SOD in the study group were lower than those in the control group, while MDA was higher than those in the control group (P<0.05). ROC curve indicated that the areas under the curves of IL-8, CRP and TXB2 were 0.725, 0.835 and 0.880, and the areas under the curves, sensitivity and specificity of the combined determination were higher than those of any index (P<0.05). In general, compared with traditional interlaminar fenestration of nucleus pulposus, combined with percutaneous endoscopic lumbar disc discectomy has a significant effect on the treatment of disc herniation, and can reduce the levels of IL-8, CRP and TXB2.

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“…Patients with LDH usually present with symptoms such as pain, numbness, and weakness, which have a significant negative influence on their social functions. Percutaneous endoscopic lumbar discectomy (PELD) was first introduced in 1992 and has been widely used in clinical practice for lumbar spine diseases due to less invasiveness and faster recovery than traditional surgery ( Aprile;Amato and de Oliveira, 2020; Hu;Zheng;Chen and Chen, 2020 ; Tacconi;Baldo;Merci and Serra, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The Thermosensitive Injectable Celecoxib-Loaded Chitosan Hydrogel for Repairing Postoperative Intervertebral Disc Defect

Tang

et al. 2022

Front. Bioeng. Biotechnol.

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Percutaneous endoscopic lumbar discectomy has been widely used in clinical practice for lumbar spine diseases. But the postoperative disc re-herniation and inflammation are the main reason for pain recurrence after surgery. The postoperative local defect of the intervertebral disc will lead to the instability of the spine, further aggravating the process of intervertebral disc degeneration. In this work, we successfully synthesized the thermosensitive injectable celecoxib-loaded chitosan hydrogel and investigated its material properties, repair effect, biocompatibility, and histocompatibility in in vitro and in vivo study. In vitro and in vivo, the hydrogel has low toxicity, biodegradability, and good biocompatibility. In an animal experiment, this composite hydrogel can effectively fill local tissue defects to maintain the stability of the spine and delay the process of intervertebral disc degeneration after surgery. These results indicated that this composite hydrogel will be a promising way to treat postoperative intervertebral disc disease in future clinical applications.

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Transforaminal percutaneous endoscopic lumbar discectomy: outcome and complications in 270 cases

Cited by 19 publications

References 14 publications

Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis

Complications and risk factors of percutaneous endoscopic transforaminal discectomy in the treatment of lumbar spinal stenosis

The effect of locating and sliding of facet combined with percutaneous endoscopic lumbar discectomy on cell inflammatory indicators and the treatment of disc herniation

The Thermosensitive Injectable Celecoxib-Loaded Chitosan Hydrogel for Repairing Postoperative Intervertebral Disc Defect

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