1. Targeted fully endoscopic visualized laminar trepanning approach under local anaesthesia for resection of highly migrated lumbar disc herniation
- Author
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Chao, Chen, Xun, Sun, Jie, Liu, Xinlong, Ma, Dong, Zhao, Haiyun, Yang, Gang, Liu, Baoshan, Xu, Zheng, Wang, and Qiang, Yang
- Subjects
Adult ,Male ,Lumbar Vertebrae ,Endoscopy ,Treatment Outcome ,Trephining ,Humans ,Diskectomy, Percutaneous ,Female ,Orthopedics and Sports Medicine ,Surgery ,Intervertebral Disc Displacement ,Anesthesia, Local ,Retrospective Studies - Abstract
To introduce a new fully endoscopic visualized laminar trepanning approach with a periendoscopic trephine under local anesthesia for resection of highly migrated lumbar disc herniation (LDH) and report the clinical outcomes of one year follow-up.Twenty-one patients with highly migrated LDH who underwent percutaneous endoscopic lumbar discectomy via the laminar trepanning approach from June 2019 to August 2020 were retrospectively reviewed. Patient-Reported Outcomes Measurement Information System (PROMIS) Short Forms-Pain Interference (PI) and Physical Function (PF) were selected as outcome measures. The operating duration and complication were documented.The average age of the 21 patients (15 males, 6 females) was 37.8 ± 6.0 years (29-52 years). Disc migration originated from L4/5 in 19 patients, L5/S1 in two patients. The mean operative duration was 54.1 ± 9.0 minutes (42-79 min). All patients were followed up to 12 months after the operation. PROMIS PI T-scores decreased significantly from pre-operatively mean 68.6 ± 2.4 to 54.4 ± 1.9 (P 0.001) and 47.1 ± 4.3 (P 0.001) at six weeks and 12 months, respectively. PROMIS PF T-scores improved significantly from pre-operatively mean 26.7 ± 4.7 to 44.3 ± 4.2(P 0.001) and 58.4 ± 4.0 (P 0.001) at six weeks and 12 months, respectively. No complications and disc herniation recurrences occurred.The targeted full endoscopic laminar trepanning under local anesthesia with a visualized periendoscopic trephine offers a safe, efficient and cost-effective option for the resection of highly migrated LDH.
- Published
- 2022