Priliminary outcomes of percutaneous transforaminal endoscopic lumbar discectomy for lumbar disc herniation

English Keywords:Lumbar disc herniation  Transforaminal  Endoscope  Discectomy

English Abstract:

  【Abstract】 Objective：To evaluate the priliminary outcomes of percutaneous transforaminal endoscopic lumbar discectomy for lumbar disc herniation.Method：From September 2009 to March 2010，30 patients who had lumbar disc herniation and undergoing transforaminal microendoscopic discectomy were reviewed retrospectively.There were 19 males and 11 females，with an average age of 40.8 years.The mean follow-up was 9.2 months，and the mean course of disease was 9 months.All patients presented with back pain and sciatica of varied degrees，all had single level involved.The pathological type of disc herniation included lateral type in 25 and paramiddian type in 5.Surgery was performed under local anesthesia.The preoperative and postoperative visual analogue scale（VAS） were used to evaluate the leg pain and the back pain.The Oswestry disability index（ODI） and the MacNab scores at 6th months of the follow-up were also evaluated.Result：All cases underwent operation successfully.The operation time was 55-135min（mean，75min） and the blood loss was 5-30ml（average 12ml）.1 case with L5/S1 lumbar disc herniation was complicated with leg pain recurrence after relief.Another 1 case with L4/5 involvement presented with decreased knee reflexes.Both were relieved by drug intervention. All patients had VAS score of low back and leg pain decreased from preoperative 6.5 and 8.7 respectively to postoperative mean 1.9 and 1.5 respectively at 6th months of the follow-up（P＜0.01）.ODI decreased from preoperative 77.38% to postoperative mean 19.09%.According to Macnab criteria，the surgical outcomes were excellent in 10（33.3%） cases，good in 16（53.3%） cases，fair in 3（10%） cases with the excellent-to-good rate of 86.6%（P＜0.01）.Conclusion：Percutaneous transforaminal endoscopic lumbar discectomy for lumbar disc herniation is reliable and effective due to its minimal invasion，less complications and good prognosis.