J Destandau1. 1. Service de Neurochirurgie, Hôpital Bagatelle, 33400 Talence. jean.destandeau@wanadoo.fr
Abstract
BACKGROUND: We analyzed the contribution of endoscopic surgery for lumbar foraminal disc herniation in a series of 191 patients. METHODS: All the patients underwent a posterior paramedian endoscopic procedure performed by the same operator. This prospective study concerned 191 consecutive patients included between April 1999 and March 2002. Outcome was assessed with a self-administered questionnaire. Prolo's criteria were used. RESULTS: Of the 191 patients, 144 questionnaires (75%) were returned showing results were excellent in 130 (90%), good in 1 (0.7%) and poor in 13 (9%). The complications observed were: aseptic discitis (n=1); approach of two levels due to incorrect fluoroscopic guidance (n=2); dural tear (n=1); partial nerve root lesion (n=3); a second operation was necessary in 4 patients but only once at the same level and on the same side. Of the 80 patients who were working before the operation, 77 were able to return to work with an average delay of 3 weeks, 2 did not return to work and one worked only part time. CONCLUSIONS: These good results associated with a high rate of patient satisfaction demonstrate that endoscopic surgery is an effective technique for the foramen. Endoscopy allow complete exposure decompression of the nerve root all along the foraminal canal.
BACKGROUND: We analyzed the contribution of endoscopic surgery for lumbar foraminal disc herniation in a series of 191 patients. METHODS: All the patients underwent a posterior paramedian endoscopic procedure performed by the same operator. This prospective study concerned 191 consecutive patients included between April 1999 and March 2002. Outcome was assessed with a self-administered questionnaire. Prolo's criteria were used. RESULTS: Of the 191 patients, 144 questionnaires (75%) were returned showing results were excellent in 130 (90%), good in 1 (0.7%) and poor in 13 (9%). The complications observed were: aseptic discitis (n=1); approach of two levels due to incorrect fluoroscopic guidance (n=2); dural tear (n=1); partial nerve root lesion (n=3); a second operation was necessary in 4 patients but only once at the same level and on the same side. Of the 80 patients who were working before the operation, 77 were able to return to work with an average delay of 3 weeks, 2 did not return to work and one worked only part time. CONCLUSIONS: These good results associated with a high rate of patient satisfaction demonstrate that endoscopic surgery is an effective technique for the foramen. Endoscopy allow complete exposure decompression of the nerve root all along the foraminal canal.
Authors: Clayton N Kraft; Tobias Krüger; Jörn Westhoff; Christian Lüring; Oliver Weber; Dieter C Wirtz; Peter H Pennekamp Journal: Acta Orthop Date: 2011-06-10 Impact factor: 3.717