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Published in: BMC Musculoskeletal Disorders 1/2020

Open Access 01-12-2020 | Lumbar Disc Herniation | Research article

Comparison of conventional fenestration discectomy with Transforaminal endoscopic lumbar discectomy for treating lumbar disc herniation:minimum 2-year long-term follow-up in 1100 patients

Authors: Quanyi Li, Yongchun Zhou

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Purpose

To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with transforaminal endoscopic lumbar discectomy (TELD) for treating lumbar disc herniation (LDH).

Methods

The clinical data of 1100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas TELD was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded.

Results

The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B.

Conclusions

Although conventional IFD and TELD had similar levels of efficacy in treating LDH, TELD had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.
Literature
1.
go back to reference Campbell P, Wynnejones G, Muller S, et al. The influence of employment social support for risk and prognosis in nonspecific back pain: a systematic review and critical synthesis. Int Arch Occup Environ. 2013;86(2):119–37.CrossRef Campbell P, Wynnejones G, Muller S, et al. The influence of employment social support for risk and prognosis in nonspecific back pain: a systematic review and critical synthesis. Int Arch Occup Environ. 2013;86(2):119–37.CrossRef
2.
go back to reference Nie HF, Zeng JC, Song YM, et al. Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation via an interlaminar approach versus a transforaminal approach: a prospective randomized controlled study with 2-year follow-up. Spine. 2016;41(19):30–7.CrossRef Nie HF, Zeng JC, Song YM, et al. Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation via an interlaminar approach versus a transforaminal approach: a prospective randomized controlled study with 2-year follow-up. Spine. 2016;41(19):30–7.CrossRef
3.
go back to reference Strmqvist F, Strmqvist B, Bo J, et al. Gender differences in patients scheduled for lumbar disc herniation surgery: a national register study including 15, 631 operations. Eur Spine J. 2016;25(1):162–7.CrossRef Strmqvist F, Strmqvist B, Bo J, et al. Gender differences in patients scheduled for lumbar disc herniation surgery: a national register study including 15, 631 operations. Eur Spine J. 2016;25(1):162–7.CrossRef
4.
go back to reference Abrishamkar S, Kouchakzadeh M, Mirhosseini A, Tabesh H, Rezvani M, Moayednia A, et al. Comparison of open surgical discectomy versus plasma-laser nucleoplasty in patients with single lumbar disc herniation. J Res Med Sci. 2015;20(12):1133–7.CrossRef Abrishamkar S, Kouchakzadeh M, Mirhosseini A, Tabesh H, Rezvani M, Moayednia A, et al. Comparison of open surgical discectomy versus plasma-laser nucleoplasty in patients with single lumbar disc herniation. J Res Med Sci. 2015;20(12):1133–7.CrossRef
5.
go back to reference Majeed SA, Vikraman CS, Mathew V, AT S. Comparison of outcomes between conventional lumbar fenestration discectomy and minimally invasive lumbar discectomy: an observational study with a minimum 2-year follow-up. J Orthop Surg Res. 2013;24(8):34.CrossRef Majeed SA, Vikraman CS, Mathew V, AT S. Comparison of outcomes between conventional lumbar fenestration discectomy and minimally invasive lumbar discectomy: an observational study with a minimum 2-year follow-up. J Orthop Surg Res. 2013;24(8):34.CrossRef
6.
go back to reference Ohtori S, Yamashita M, Yamauchi K, Inoue G, Koshi T, Suzuki M, et al. Low back pain after lumbar discectomy in patients showing endplate modic type 1 change. Spine (Phila Pa 1976). 2010;35(13):E596–600.CrossRef Ohtori S, Yamashita M, Yamauchi K, Inoue G, Koshi T, Suzuki M, et al. Low back pain after lumbar discectomy in patients showing endplate modic type 1 change. Spine (Phila Pa 1976). 2010;35(13):E596–600.CrossRef
7.
go back to reference Ahn Y. Transforaminal percutaneous endoscopic lumbar discectomy: technical tips to prevent complications. Expert Rev Med Devices. 2012;9(4):361–6.CrossRef Ahn Y. Transforaminal percutaneous endoscopic lumbar discectomy: technical tips to prevent complications. Expert Rev Med Devices. 2012;9(4):361–6.CrossRef
8.
go back to reference Sairyo K, Chikawa T, Nagamachi A. State-of-the-art Transforaminal percutaneous endoscopic lumbar surgery under local anesthesia: discectomy, Foraminoplasty, and ventral Facetectomy. J Orthop Sci. 2018;23(2):229–36.CrossRef Sairyo K, Chikawa T, Nagamachi A. State-of-the-art Transforaminal percutaneous endoscopic lumbar surgery under local anesthesia: discectomy, Foraminoplasty, and ventral Facetectomy. J Orthop Sci. 2018;23(2):229–36.CrossRef
9.
go back to reference Li J, Ma C, Li Y, Liu G, Dong W, Dai W, et al. A comparison of results between transforaminal endoscopic lumbar discectomy and fenestration discectomy for lumbar disc herniation in the Adolscents. Zhonghua Yi Xue Za Zhi. 2015;95(47):3852–5.PubMed Li J, Ma C, Li Y, Liu G, Dong W, Dai W, et al. A comparison of results between transforaminal endoscopic lumbar discectomy and fenestration discectomy for lumbar disc herniation in the Adolscents. Zhonghua Yi Xue Za Zhi. 2015;95(47):3852–5.PubMed
10.
go back to reference Ding W, Yin J, Yan T, Nong L, Xu N. Meta-analysis of transforaminal endoscopic lumbar discectomy vs. fenestration discectomy in the treatment of lumbar disc herniation. Orthopade. 2018;47(7):574–84.CrossRef Ding W, Yin J, Yan T, Nong L, Xu N. Meta-analysis of transforaminal endoscopic lumbar discectomy vs. fenestration discectomy in the treatment of lumbar disc herniation. Orthopade. 2018;47(7):574–84.CrossRef
11.
go back to reference Kim M, Lee S, Kim H-S, Park S, Shim S-Y, Lim D-J. A comparison of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for lumbar disc herniation in the Korean: a meta-analysis. Biomed Res Int. 2018;2018:9073460.PubMedPubMedCentral Kim M, Lee S, Kim H-S, Park S, Shim S-Y, Lim D-J. A comparison of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for lumbar disc herniation in the Korean: a meta-analysis. Biomed Res Int. 2018;2018:9073460.PubMedPubMedCentral
12.
go back to reference Li J, Ma C, Li YM, Wang ZH, Zhao M, Feng J, et al. Comparison of results between fenestration discectomy associated with annulus repair and fenestration discectomy for lumbar disc herniation in the adolescents. Zhonghua Yi Xue Za Zhi. 2016;96(32):2573–7.PubMed Li J, Ma C, Li YM, Wang ZH, Zhao M, Feng J, et al. Comparison of results between fenestration discectomy associated with annulus repair and fenestration discectomy for lumbar disc herniation in the adolescents. Zhonghua Yi Xue Za Zhi. 2016;96(32):2573–7.PubMed
13.
go back to reference Kim HS, Wu PH, Jang IT. Lumbar degenerative disease part 1: anatomy and pathophysiology of intervertebral Discogenic pain and radiofrequency ablation of Basivertebral and Sinuvertebral nerve treatment for chronic Discogenic Back pain: a prospective case series and review of literature. Int J Mol Sci. 2020;21(4):E1483.CrossRef Kim HS, Wu PH, Jang IT. Lumbar degenerative disease part 1: anatomy and pathophysiology of intervertebral Discogenic pain and radiofrequency ablation of Basivertebral and Sinuvertebral nerve treatment for chronic Discogenic Back pain: a prospective case series and review of literature. Int J Mol Sci. 2020;21(4):E1483.CrossRef
14.
go back to reference Fairbank JC. Oswestry disability index. J Neurosurg Spine. 2014;20(2):239–41.CrossRef Fairbank JC. Oswestry disability index. J Neurosurg Spine. 2014;20(2):239–41.CrossRef
15.
go back to reference Azimi P, Benzel EC. The low-Back outcome scale and the Oswestry disability index: are they reflective of patient satisfaction after discectomy? A cross sectional study. J Spine Surg. 2017;3(4):554–60.CrossRef Azimi P, Benzel EC. The low-Back outcome scale and the Oswestry disability index: are they reflective of patient satisfaction after discectomy? A cross sectional study. J Spine Surg. 2017;3(4):554–60.CrossRef
16.
go back to reference Casal-Moro R, Castro-Menendez M, Hernandez Blanco M, Bravo-Ricoy JA, Jorge-Barreiro FJ. Long-term outcome after microendoscopic diskectomy for lumbar disk herniation: a prospective clinical study with a 5-year follow-up. Neurosurgery. 2011;68:1568–75.CrossRef Casal-Moro R, Castro-Menendez M, Hernandez Blanco M, Bravo-Ricoy JA, Jorge-Barreiro FJ. Long-term outcome after microendoscopic diskectomy for lumbar disk herniation: a prospective clinical study with a 5-year follow-up. Neurosurgery. 2011;68:1568–75.CrossRef
17.
go back to reference Wenger M, Mariani L, Kalbarczyk A, Groger U. Long-term outcome of 104 patients after lumbar sequestrectomy according to Williams. Neurosurgery. 2001;49:329–34.PubMed Wenger M, Mariani L, Kalbarczyk A, Groger U. Long-term outcome of 104 patients after lumbar sequestrectomy according to Williams. Neurosurgery. 2001;49:329–34.PubMed
18.
go back to reference Gadjradj PS, van Tulder MW, Dirven CM, Peul WC, Harhangi BS. Clinical outcomes after transforaminal endoscopic lumbar discectomy for lumbar disc herniation: a prospective case series. Neurosurg Focus. 2016;40(2):E3.CrossRef Gadjradj PS, van Tulder MW, Dirven CM, Peul WC, Harhangi BS. Clinical outcomes after transforaminal endoscopic lumbar discectomy for lumbar disc herniation: a prospective case series. Neurosurg Focus. 2016;40(2):E3.CrossRef
19.
go back to reference Chen Z, Zhang L, Dong J, Xie P, Liu B, Wang Q, et al. Transforaminal endoscopic lumbar discectomy compared with microendoscopic discectomy for lumbar disc herniation: 1-year results of an ongoing randomized controlled trial. J Neurosurg Spine. 2018;28(3):300–10.CrossRef Chen Z, Zhang L, Dong J, Xie P, Liu B, Wang Q, et al. Transforaminal endoscopic lumbar discectomy compared with microendoscopic discectomy for lumbar disc herniation: 1-year results of an ongoing randomized controlled trial. J Neurosurg Spine. 2018;28(3):300–10.CrossRef
20.
go back to reference Kim HS, Paudel B, Jang JS, Lee K, Oh SH, Jang IT. Percutaneous endoscopic lumbar discectomy for all types of lumbar disc Herniations (LDH) including severely difficult and extremely difficult LDH cases. Pain Phys. 2018;21(4):E401–8. Kim HS, Paudel B, Jang JS, Lee K, Oh SH, Jang IT. Percutaneous endoscopic lumbar discectomy for all types of lumbar disc Herniations (LDH) including severely difficult and extremely difficult LDH cases. Pain Phys. 2018;21(4):E401–8.
21.
go back to reference Choi KC, Kim JS, Lee DC, Park CK. Percutaneous endoscopic lumbar discectomy: minimally invasive technique for multiple episodes of lumbar disc herniation. BMC Musculoskelet Disord. 2017;18(1):329.CrossRef Choi KC, Kim JS, Lee DC, Park CK. Percutaneous endoscopic lumbar discectomy: minimally invasive technique for multiple episodes of lumbar disc herniation. BMC Musculoskelet Disord. 2017;18(1):329.CrossRef
Metadata
Title
Comparison of conventional fenestration discectomy with Transforaminal endoscopic lumbar discectomy for treating lumbar disc herniation:minimum 2-year long-term follow-up in 1100 patients
Authors
Quanyi Li
Yongchun Zhou
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03652-0

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