Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 8/2015

01-08-2015 | Original Paper

Evaluation of transforaminal endoscopic lumbar discectomy in the treatment of lumbar disc herniation

Authors: Kun Wang, Xin Hong, Bao-Yi Zhou, Jun-Ping Bao, Xin-Hui Xie, Feng Wang, Xiao-Tao Wu

Published in: International Orthopaedics | Issue 8/2015

Login to get access

Abstract

Purpose

The purpose of this study was to evaluate the efficacy of transforaminal endoscopic lumbar discectomy (TELD) in the treatment of lumbar disc herniation (LDH) and to identify the relationship between TELD efficacy and age.

Methods

A total of 207 consecutive LDH patients who had undergone TELD with the THESSYS system from January 2013 to September 2014 were divided into two groups on the basis of their age, with 108 cases in the ≤45-year-old age group and 99 cases in the >45-year-old group. The Oswestry Disability Index (ODI) was used to quantify the pain relief. The degree of pain and disability were measured on the basis of the visual analog scale (VAS) and the modified MacNab criteria. Complications, duration of hospital stay, surgical costs, and operation time were recorded and compared between the two groups. Spearman’s coefficient of rank correlation was used to assess the learning curves for TELD.

Results

The mean pre-operative and postoperative VAS and ODI scores significantly improved in both age ≤45 group and age >45 group, with no significant differences between them. In age ≤45 group, 56 % had excellent outcomes, 28 % good, 14 % fair, and 3 % poor. In the age >45 group, 51 % had excellent outcomes, 20 % good, 25 % fair, and 4 % poor. The average lengths of hospital stay for the age ≤45 group and age >45 group were 6.8 and 8.4 days, respectively. The mean time to return to work or normal activities was ten days for the age ≤45 group and 15 days for the age >45 group. The mean operative time for the age ≤45 group was 94 minutes and that for age >45 group was 97 minutes. The surgical cost of age ≤45 group was 15,480 RMB, which was lower than the 16,381 RMB of age >45 group. A total of 14 patients in the age ≤45 group and 13 patients in age >45 group used analgesic medications. Three and five recurrences were reported in the age ≤45 group and age >45, respectively. The steep learning curves of operative time plotted against the number of surgeries conducted suggest that the TELD technique can be mastered quickly in terms of reducing the duration of operation.

Conclusions

The efficacy of TELD is relatively good for the selected young and elderly patients in this study. Therefore, age is not a predictor of TELD surgery-related outcomes.
Literature
1.
Dagenais S, Caro J, Haldeman S (2008) A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J 8:8–20PubMedCrossRef
2.
Tosteson AN, Tosteson TD, Lurie JD, Abdu W, Herkowitz H et al (2011) Comparative effectiveness evidence from the spine patient outcomes research trial: surgical versus nonoperative care for spinal stenosis, degenerative spondylolisthesis, and intervertebral disc herniation. Spine (Phila Pa 1976) 36:2061–2068CrossRef
3.
Chung RS, Ahmed N (2010) The impact of minimally invasive surgery on residents' open operative experience: analysis of two decades of national data. Ann Surg 251:205–212PubMedCrossRef
4.
Lee SH, Chung SE, Ahn Y, Kim TH, Park JY et al (2006) Comparative radiologic evaluation of percutaneous endoscopic lumbar discectomy and open microdiscectomy: a matched cohort analysis. Mt Sinai J Med 73:795–801PubMed
5.
Jasper GP, Francisco GM, Telfeian AE (2013) Clinical success of transforaminal endoscopic discectomy with foraminotomy: a retrospective evaluation. Clin Neurol Neurosurg 115:1961–1965PubMedCrossRef
6.
Kim MJ, Lee SH, Jung ES, Son BG, Choi ES et al (2007) Targeted percutaneous transforaminal endoscopic diskectomy in 295 patients: comparison with results of microscopic diskectomy. Surg Neurol 68:623–631PubMedCrossRef
7.
Arts MP, Brand R, van den Akker ME, Koes BW, Bartels RH et al (2011) Tubular diskectomy vs conventional microdiskectomy for the treatment of lumbar disk herniation: 2-year results of a double-blind randomized controlled trial. Neurosurgery 69:135–144, discussion 144PubMedCrossRef
8.
Heliövaara M (1988) Epidemiology of sciatica and herniated lumbar intervertebral disc. Social Insurance Institution, Research Institute for Social Security, Rehabilitation Research Centre, University of Michigan, USA
9.
Jonsson B, Stromqvist B (1995) Influence of age on symptoms and signs in lumbar disc herniation. Eur Spine J 4:202–205PubMedCrossRef
10.
Peul WC, Brand R, Thomeer RT, Koes BW (2008) Influence of gender and other prognostic factors on outcome of sciatica. Pain 138:180–191PubMedCrossRef
11.
Bydon M, Macki M, De la Garza-Ramos R, Sciubba DM, Wolinsky JP et al (2015) Smoking as an independent predictor of reoperation after lumbar laminectomy: a study of 500 cases. J Neurosurg Spine 22(3):288–293
12.
Halldin K, Lind B, Ronnberg K, Gothlin J, Gadeholt-Gothlin G et al (2009) Three-dimensional radiological classification of lumbar disc herniation in relation to surgical outcome. Int Orthop 33:725–730PubMedCentralPubMedCrossRef
13.
14.
Ren L, Guo H, Zhang T, Han Z, Zhang L et al (2013) Efficacy evaluation of percutaneous laser disc decompression in the treatment of lumbar disc herniation. Photomed Laser Surg 31:174–178PubMedCrossRef
15.
Fujii K, Henmi T, Kanematsu Y, Mishiro T, Sakai T (2003) Surgical treatment of lumbar disc herniation in elderly patients. J Bone Joint Surg 85:1146–1150CrossRef
16.
Metadata
Title
Evaluation of transforaminal endoscopic lumbar discectomy in the treatment of lumbar disc herniation
Authors
Kun Wang
Xin Hong
Bao-Yi Zhou
Jun-Ping Bao
Xin-Hui Xie
Feng Wang
Xiao-Tao Wu
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 8/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2747-1

Other articles of this Issue 8/2015

International Orthopaedics 8/2015 Go to the issue

Original Paper

Factors affecting range of motion after total knee arthroplasty in patients with more than 120 degrees of preoperative flexion angle

Original Paper

Anthropometric study of the proximal radius: does radial head implant fit in all cases?

Original Paper

Impact and alternative metrics for medical publishing: our experience with International Orthopaedics

Original Paper

Patient-specific implants for lateral unicompartmental knee arthroplasty

Original Paper

Arthroplasty in patients with extensive femoral head avascular necrosis

Original Paper

Prospective clinical trial of patients who underwent ankle arthroscopy with articular diseases to match clinical and radiological scores with intra-articular cytokines