Percutaneous endoscopic lumbar discectomy for migrated lumbar disc herniation via contralateral transforaminal approach

English Keywords:Lumbar disc herniations  Percutaneous endoscopic lumbar discectomy  Migrated  Contralateral

English Abstract:

  【Abstract】 Objectives: To investigate the safety and feasibility of percutaneous endoscopic lumbar discectomy(PELD) via contralateral transforaminal approach. Methods： From February 2010 to February 2012, 12 patients suffering from migrated lumbar disc herniation were treated by this method. 3 patients were at L3/4 and 9 patients were at L4/5. Patients′ intraoperative response and tolerance were observed. Operation time and postoperative complications were recorded. Patients′ radicular pain and daily life function were evaluated by the visual analog scale(VAS) and Oswestry disability index(ODI) scores. Outcomes were graded by modified Macnab criteria. Results: All the patients tolerated the operation without special complaints. Mean operation time was 110±20mins. One patient had the symptom of coccygeal nerve injury deteriorated after operation, which relieved after 3-month conservative treatment. The rest patients presented with no neurological, vascular or dural injury. Patients were followed up for 12-24 months, mean follow-up time was 18±2.5 months. Mean VAS score improved from 7.75±0.97 at preoperation to 2.42±0.79 at the first day of postoperation, and to 1.42±0.79 at last follow-up, which showed significant differences compared with the preoprative. Mean ODI score improved from 57.67±9.57 at preoperation to 8.50±3.73 at last follow-up, which also showed significant differences. Radicular pain and daily life function improved obviously. Excellent was noted in 8 patients, good in 3 patients, fair in 1 patient, with the satisfactory rate of 91.67%(11/12). Conclusions: PELD via contralateral transforaminal approach is safe and feasible for migrated lumbar disc herniation.