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《Chinese Journal of Reparative and Reconstructive Surgery》 2015-01
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EFFECTIVENESS OF PERCUTANEOUS ENDOSCOPIC TRANSFORAMINAL DISCECTOMY FOR RECURRENT LUMBAR DISC HERNIATION

LI Zhuhai;ZENG Jiancheng;SONG Yueming;KONG Qingquan;WANG Xiandi;CHEN Guo;NIE Hongfei;JIANG Hushan;Department of Orthopedic Surgery,West China Hospital,Sichuan University;  
Objective To determine the feasibility and effectiveness of percutaneous endoscopic transforaminal discectomy(PETD) for recurrent lumbar disc herniation(RLDH). Methods Between June 2009 and December 2011,56 patients with RLDH underwent PETD after local anesthesia,including 30 males and 26 females,with a mean age of 50 years(range,24-70 years). The involved segments were L3,4 in 3 cases,L4,5 in 34 cases,and L5-S1 in 19 cases. Of 56 patients,48 suffered from ipsilateral re-herniation,and 8 suffered from contralateral re-herniation. All the patients had a mean pain-free interval of 5.5 years(range,6 months to 27 years). The visual analogue scale(VAS) score for back pain was 6.18±1.44 and the VAS score for leg pain was 7.66±1.03. Postoperative effectiveness was assessed based on the VAS score and modified Mac Nab criteria. Results The mean operation time was 60.4 minutes(range,30-100 minutes) and the mean duration of hospital stay was 5.1 days(range,3-6 days). All patients were followed up 28.2 months on average(range,24-56 months). Patients obtained immediate pain relief postoperatively. The postoperative VAS scores of back and leg pain at 1 month,3 months,12 months,and last follow-up were significantly decreased when compared with preoperative score(P0.05). Based on the modified Mac Nab criteria,the results were excellent in 39 cases,good in 9 cases,fair in 5 cases,and poor in 3 cases at 12 months after operation,and the excellent and good rate was 85.7%. Surgery-related complications were found in 5 cases(8.9%); one patient(1.8%) suffered from recurrence at 18 months postoperatively,and the symptom was relieved after open lumbar discectomy and intervertebral fusion surgery. Conclusion PETD has several advantages in treating RLDH,such as avoiding from the old scar tissue,decreasing operation-related complications,shortening operation time,reducing trauma,and obtaining rapid postoperative recovery. This technique is feasible and effective for RLDH.
【Fund】: 卫生公益性行业科研专项经费资助项目(201002018)~~
【CateGory Index】: R687.3
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【Co-citations】
Chinese Journal Full-text Database 9 Hits
1 SHEN Cai-jia1,FAN Hai-tao2,ZHAO Yong1,et al.(1.Anhui Taihe County People's Hospital,236600;2.The first Affiliated Hospital of Anhui Medical University,23000,China);The clinical efficacy of interbody fusion combined with internal fixation for the treatment of recurrent disc herniation[J];The Journal of Cervicodynia and Lumbodynia;2012-06
2 ZHAO Xiang;HE Sheng-hua;DING Hao;FANG Jun;Dept of Orthopaedics,Traditional Chinese Medicine Hospital of Wuhu City;;Percutaneous endoscopic lumbar discectomy for treatment of young patient with lumbar disc herniation[J];Journal of Clinical Orthopaedics;2014-05
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5 CHEN Yin-he;WU Yi-le;SHEN Cai-liang;Department of Orthopaedic Surgery,1st Affiliated Hospital of Anhui Medical University;Department of Epidemiology and Statistics,School of Public Health,Anhui Medical University;;Meta-analysis of the Relationship between Gender or Smoking and Recurrent Lumbar Disc Herniation[J];Journal of Practical Orthopaedics;2014-06
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7 MENG Fan-xing;PENG Jia-bin;Outpatient Department,Institute of Chemical Defense;;Relevant factors of recurrence in lumbar intervertebral disc herniation after lumber discectomy[J];Medical Journal of General Equipment Headquarters;2014-01
8 Liu Meng-jun;Du Bin;Wei Xin-wei;Wang Shi-hai;Lin Qing;Wang Song;Chen Zhi-xin;First Clinical Medical College of Lanzhou University;First Department of Orthopedics,Gansu Provincial People's Hospital;;Microsurgical discectomy versus microendoscopic discectomy for treatment of lumbar disc herniations: a meta-analysis[J];Chinese Journal of Tissue Engineering Research;2014-31
9 FANG Miao;DU Ming-kui;KUANG Zheng-da;Orthopedics Department,Armed Police General Hospital;;Intervertebral Foramen Endoscope in the Treatment of Lumbar Disc Herniation[J];Medical Recapitulate;2014-12
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