Percutaneous transforaminal endoscopic discectomy to manage recurrent lumbar disc herniation

English Keywords:Lumbar disc herniation  Percutaneous endoscopic discectomy  Transforaminal  Recurrent

English Abstract:

  【Abstract】 Objective：To investigate a 2-year follow-up outcome and associated complications of percutaneous endoscopic lumbar discectomy for recurrent disc herniation.Method：Thirty-two patients with diagnosis of recurrent lumbar disc herniation undergoing percutaneous endoscopic transforminal lumbar discectomy under local anesthesia were reviewed retrospectively.There were 22 males and 10 females.The levels of recurrence were L3/4 in seven cases，L4/5 in 22 cases and L5/S1 in 3 cases.The mean follow up time was 30 months（range，24-45 months）.Result：The operation time was 25-60min（mean，40min）.Two（6%） cases were complicated with dural matter tear in 1 and transient dysesthesia in 1.According to Macnab criteria，the surgical outcomes were excellent in 10（31.2%） cases，good in 16（50%）cases，fair in 3（9.4%） cases and poor in 3（9.4%） cases. Twenty-six（81.2%） patients got satisfactory result，another 6 cases unsatisfied with outcome returned to conventional decompression and fusion protocol.The preoperative mean VAS was 7.8 which decreased to postoperative mean 2.4 at final follow up（P<0.001）.Conclusion：Percutaneous transforaminal endoscopic discectomy for recurrent lumbar disc herniation has less complication and less operation time for its obviation of dealing with epidural scar tissue and the interference with bony structure.We recommend percutaneous endoscopic transforaminal lumbar discectomy for recurrent lumbar disc herniation on the basis of posterior elements remaining intact.