The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Percutaneous transforaminal endoscopic discectomy for recurrent disc herniation secondary to open laminectomy and discectomy

Author : WANG Xiu-ting, LI Si-sheng, SUN Jian, ZHANG Mei-ling, MAO Feng-mei.     
Working unit : Department of Spinal Surgery, The Seventh People's Hospital of Zibo City, Zibo 255000, China
Page : 881-886.
Key words : lumbar disc herniation, recurrence, percutaneous transforaminal endoscopic discectomy (PTED) , posterior lumbar interbody fusion (PLIF)
Abstract: [Objective] To explore the advantages and disadvantages of percutaneous transforaminal endoscopic discectomy (PTED) for recurrent lumbar disc herniation secondary to open laminectomy and discectomy. [Methods From July 2015 to October 2018, 68 patients who suffered from recurrent lumbar disc herniation secondary to open laminectomy and discectomy were enrolled into this study, and divided into two groups by random number table method. Of them, 34 patients received PTED, while the remaining 34 patient underwent the modified posterior lumbar interbody fusion (PLIF) . The documentations, including clinical, laboratory test and image data were compared between the two group. [Results] All the patients in both group had surgical procedures performed smoothly without serious complications. The PTED group proved significantly superior to the PLIF group regarding operation time, incision length, intraoperative blood loss, bed rest time and hospital stay (P<0.05) , nevertheless the PTED group got significantly more fluoroscopy frequency, and greater radiation exposure than the PLIF group (P< 0.05) . The follow-up period lasted for 12~18 months. As time went both VAS and ODI scores in both groups significantly decreased (P<0.05) . The PTED group had significantly lower VAS score than the PLIF group at 3 weeks after operation (P<0.05) ,which became statistically insignificant between the two groups from 6 months to 12 months postoperatively (P>0.05) . In addition, the PTED group had significantly lower ODI scores than the PLIF group at 3 weeks, 3 months and 6 months after operation (P<0.05) , which turned to be not statistically significant at 12 months postoperatively (P>0.05) . Regarding to laboratory tests, the PTED group had significantly lower CRP and CK at 3 days afer operation than the PLIF group (P<0.05) . In term of radiographic assessment, no remarkable instability of the involved segment, and no prominent worsening of adjacent segment degeneration was found in any patient of the PTEDgroup at the latest follow up. On the other hand, bony fusion of involved segment achieved in all patients of the PLIF group without implant loosening. [Conclusion] The PTED achieves satisfactory clinical outcomes similar to the PLIF for recurrent disc herniation, and has benefits of minimal trauma, earlier recovery and less impact on spinal stability, whereas disadvantage of greater radiation exposure.
summary:
Percutaneous transforaminal endoscopic discectomy for recurrent disc herniation secondary to open laminectomy and discectomy   
WANG Xiu-ting, LI Si-sheng, SUN Jian, ZHANG Mei-ling, MAO Feng-mei.
Orthop J Chin, 28(11):   881-886.