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

Indication of foraminoplasty on S1 superior articular process during transforaminal endoscopic discectomy for L5-S1 disc

Author : ZOU Hai-bo, WANG Yu-ming.     
Working unit : Department of Orthopedics, China-Japan Friendship Hospital, Beijing 100029, China
Page : 2240-2243
Key words : lumbar disc herniation, L5-S1 disc, S1 superior articular process, percutaneous endoscopic transforaminal discectomy, foraminoplasty
Abstract: [Objective] To investigate the clinical indication of foraminoplasty on S1 superior articular process during transforaminal endoscopic discectomy for L5-S1 disc herniation. [Methods] A retrospective study was done on 48 patients who underwent transforaminal endoscopic discectomy for L5-S1 disc herniation. During operation, whether or not foraminoplasty on the S1 superior articular process conducted was determined by Choi's classification of iliac crest height, and McCulloch's three-story positioning theory for lumbar disc herniation. The visual analogue scale (VAS) for pain, Oswestry Disability Index (ODI) , and MacNab grading system were used for evaluation of the clinical consequences. [Results] Of 48 patients, 34 had the prolapsed discs on the third floor that needed foraminoplasty of the S1 superior articular process, while among 34 patients with prolapsed disc on the third floor, 17 patients who belonged to type 5 or type 6 needed foraminoplasty of the S1 superior articular process according to Choi's classification of iliac crest height. All the patients had operation performed smoothly. The VAS score of lower back pain significantly decreased from (7.22±2.63) preoperatively to (1.69±1.89) at the latest follow up with a statistical difference (P<0.05) . In addition, the VAS score of leg pain significantly decreased from (7.92±1.25) before operation to (2.11±1.85) at the latest follow up with statistical significance (P<0.05) . Moreover, the ODI score also significantly reduced from (67.10± 18.67) preoperatively to (56.08±25.73) at the latest follow-up, there was statistically significance (P<0.05) . [Conclusions] For the L5-S1 disc herniation, if the prolapsed disc is located at the third floor or the height of iliac crest belongs to the type 5 or 6, it is necessary to do the foraminoplasty of the S1 superior articular process during percutaneous endoscopic transforaminal discectomy.
summary:
Indication of foraminoplasty on S1 superior articular process during transforaminal endoscopic discectomy for L5-S1 disc   
ZOU Hai-bo, WANG Yu-ming.
Orthop J Chin,2018,26(24):   2240-2243