Our experience of endoscopic microdiscectomy in hernias of intervertebral discs
Objective. To estimate the efficacy of transforamenal endoscopic microdiscectomy, to reveal the faults and advantages of this method, comparing with standard procedures, basing on the data obtained, the main indications and contraindications for this procedure must be determined.
Маterials and methods. There were analyzed 290 cases of the disease іn patients with hernias of lumbar part of vertebral column, who were stationary treated in Regional Centre of Orthopedics, Traumatology and Vertebrology of the Rivne Regional Clinical Hospital and in the Department of Vertebral Surgery of the Institute of Traumatology and Orthopedics NAMS of Ukraine from April 2016 till April 2018 yr. Among them were 156 women and 134 men, ageing 20 - 84 yrs old. Preoperatively in all the patients a magnet-resonance tomography or computeric tomography of lumbar part of vertebral column, functional rentgenography, and general clinical examination were conducted.
Results. In postoperative period in accordance to international questionnaire for the quality of life (Oswestry) a median index, concerning the investigated patients, have constituted 21.1%, what means a good result. Preoperative pain syndrome in accordance to a visual-analogue scale was estimated as 8.5 points, аnd in 6 mo postoperatively - as 1.5 points (lumbalgia prevailed and a radiculitis pain was almost absent). Significant practical experience of the endoscopic transforamenal microdiscectomy performance have witnessed, that a surgeon may meet a certain difficulties in a case of a sequester cranial or caudal migration, in some observations the operative access on level of L5 - S1 is complicated because of high localization of iliac crest, but if correct indications applied this procedure makes possible to eliminate the compressive radicular syndrome in a short term.
Conclusion. Application of transforamenal endoscopic microdiscectomy in treatment of patients with hernias of intervertebral discs have confirmed a quite high efficacy of this procedure and its advantages.
2. Caspar W. A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach. Advances in Neurosurg. 1977;4:74-7. doi: 10.1007/978-3-642-66578-3_15.
3. Kambin P. History of disc surgery.Arthroscopic microdiscectomy. Baltimore; 1991. 86 р.
4. Hoogland Т, Schubert M, Miklitz B. Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine (Phila Pa 1976). 2006 Nov 15;31(24):E890-7. doi: 10.1097/01.brs.0000245955.22358.3a.
5. Rutten S. Endoscopic lumbar disc surgery. Manual of Spine Surgery. Springler, Heidelberg, New York, Dordreccht, London.2012. 303 р. doi: 10.1007/978-3-642-22682-3_43.
6. Ahn Y, Lee S. Outcome predictors of percutaneous endoscopic lumbar discectomy and thermal annuloplasty for discogenic low back pain. Acta Neurochir. 2010 Oct;152(10):1695-702. doi: 10.1007/s00701-010-0726-2.
7. Wang H, Huang B, Li C, Zhang Z, Wang J, Zheng W, Zhou Y. Learning curve for percutaneous endoscopic lumbar discectomy depending on the surgeon's training level of minimally invasive spine surgery. Clin Neurol Neurosurg. 2013 Oct;115(10):1987-91. doi: 10.1016/ j.clineuro.2013.06.008.
8. Rutten S, Komp M, Hanh P. Decompression of lumbar lateral spinal stenosis: full - endoscopic, interlaminar technique. Oper Orthop Traumatol. 2013 Feb;25(1):31-46. doi: 10.1007/s00064-012-0195-2.
9. Ruetten S, Komp M, Merk H, Godolias G. Recurrent lumbar disc herniation after conventional discectomy: a prospective, randomized study comparing fullendoscopic interlaminar and transforaminal versus microsurgical revision. J Spinal Disord Tech. 2009 Apr;22(2):122-9.doi: 10.1097/BSD.0b013e318175ddb4.
This work is licensed under a Creative Commons Attribution 4.0 International License.