Journal of the Medical Association of Thailand = Chotmaihet thangphaet · 2011
Full endoscopic lumbar discectomy via interlaminar approach: 2-year results in Ramathibodi Hospital.
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Chumnanvej Sorayouth, Kesornsak Withawin, Sarnvivad Prasert, Paiboonsirijit Sompoch, Kuansongthum Verapan
Аннотация
OBJECTIVE: To present the surgical outcome of the full-endoscopic lumbar discectomy via interlaminar approach.
MATERIAL AND METHOD: Analysis of the prospectively collected data. The indication for full endoscopic discectomy is the same as for microscopic discectomy. Sixty consecutive patients with lumbar disc herniation were included. Full-endoscopic discectomy via interlaminar approach were done in all cases. The Visual analog scale (VAS), Thai version of modified Oswestry Disability Index (ODI), Macnab score, neurological symptoms, and complications were collected and followed for two years.
RESULTS: Mean follow-up period was 26 months. Excellent outcomes as defined by Macnab criteria were found in fifty-five of sixty patients (91.6%). The authors found two cases of recurrent disc herniation, which were re-operated by the same method and the symptoms were completely resolved later in the follow up period. There were two cases of persistent radicular pain after the operation, which were completely resolved after selective epidural nerve root injection. There was no serious neurological deficit, dura tear, or cauda equina syndrome in the present study series.
CONCLUSION: Full-endoscopic lumbar discectomy is a safe and effective procedure for lumbar disc herniation. Patients can expect less postoperative pain, early recovery, and a short period of work absence. However, the learning curve is steep. Proper surgical training and careful patient selection in the early cases are the keys to success.
MATERIAL AND METHOD: Analysis of the prospectively collected data. The indication for full endoscopic discectomy is the same as for microscopic discectomy. Sixty consecutive patients with lumbar disc herniation were included. Full-endoscopic discectomy via interlaminar approach were done in all cases. The Visual analog scale (VAS), Thai version of modified Oswestry Disability Index (ODI), Macnab score, neurological symptoms, and complications were collected and followed for two years.
RESULTS: Mean follow-up period was 26 months. Excellent outcomes as defined by Macnab criteria were found in fifty-five of sixty patients (91.6%). The authors found two cases of recurrent disc herniation, which were re-operated by the same method and the symptoms were completely resolved later in the follow up period. There were two cases of persistent radicular pain after the operation, which were completely resolved after selective epidural nerve root injection. There was no serious neurological deficit, dura tear, or cauda equina syndrome in the present study series.
CONCLUSION: Full-endoscopic lumbar discectomy is a safe and effective procedure for lumbar disc herniation. Patients can expect less postoperative pain, early recovery, and a short period of work absence. However, the learning curve is steep. Proper surgical training and careful patient selection in the early cases are the keys to success.