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| LI Changqing,ZHOU Yue,WANG Jian.Minimally invasive targeted percutaneous endoscopic lumbar discectomy for lumbar disc herniation[J].Chinese Journal of Spine and Spinal Cord,2013,(3):193-197. |
| Minimally invasive targeted percutaneous endoscopic lumbar discectomy for lumbar disc herniation |
| Received:December 11, 2012 Revised:January 17, 2013 |
| English Keywords:Lumbar disc herniation Percutaneous endoscopic lumbar discectomy Minimally invasive spine surgery Targeted surgery |
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| English Abstract: |
| 【Abstract】 Objectives: To determine the safety and efficacy of minimally invasive targeted percutaneous endoscopic lumbar discectomy(PELD) for lumbar disc herniation. Methods: A retrospective review was performed on 237 patients(144 males and 93 females) with lumbar disc herniation between October 2009 and March 2012. The average age was 44.8 years old. All patients presented with typical low back pain and sciatica, and were confirmed as single level lumbar disc herniation by CT and MRI. After local anesthesia, percutaneous targeted puncture was placed through a 18G long needle assisted by C-arm monitoring. Then, the guiding wire was placed through the needle, the series of tubes expanded the soft tissue over the wire, the part of the facet was removed by reamers, the working tube was placed on the herniated disc, finally PELD was performed assisted by TESSYSTM system. The pain and daily activity was evaluated by the visual analog score(VAS) and the Oswestry disability index(ODI) respectively. Modified MacNab criteria were employed to measure the clinical results. Results: The mean operation time was 53min, the mean blood loss was 20ml， no complication was noted. The patients were permitted to move wearing hard waist 3 hours after operation. The mean follow-up period was 15.5 months(range，12-24 months) in 212 patients. The mean VAS improved from 7.8±3.6 at preoperation to 1.8±1.1 at last follow-up. The mean ODI was improved from (53.2±13.5)% to (17.3±6.4)%. After 12 months after operation, 95.8% of patients showed excellent(167 patients) or good(36 patients) outcomes according to the modified MacNab criteria. 5 patients(2.4%) suffered from recurrent herniation after 7-20 months, and another microendoscopic discectomy(MED) was performed. Conclusions: Minimally invasive targeted percutaneous endoscopic lumbar discectomy is safe and effective for lumbar disc herniation. |
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