Katsuhiko Ishibashi1,2, Yasushi Oshima1,2,3, Hirokazu Inoue1,2,4, Yuichi Takano1,2, Hiroki Iwai1,2, Hirohiko Inanami1,2, Hisashi Koga1,2. 1. Department of Orthopaedics, Iwai Orthopaedic Medical Hospital, Tokyo, Japan. 2. Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital, Tokyo, Japan. 3. Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan. 4. Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
Abstract
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) is a relatively less invasive treatment for lumbar disc herniation (LDH). This study investigated the usefulness of a full-endoscopic system for PELD to treat L5 nerve root compression caused by lumbar foraminal stenosis (L5-LFS). METHODS: Between November 2016 and December 2017, a total of 10 patients with unilateral leg pain due to L5-LFS underwent surgery using a full-endoscopic system for PELD. Patients with bilateral L5-LFS or L5-LFS with coexisting LDH and/or spondylolysis were excluded from this study. A percutaneous endoscopic translaminar approach (PETA) was performed via the ipsilateral vertebral isthmus using a 3.5-mm diameter high-speed drill. Preoperative and postoperative statuses were evaluated using the modified Japanese Orthopedic Association (mJOA) and Numerical Rating Scale (NRS) scores. RESULTS: The patients' mean age was 62.2 years; there were 7 male and 3 female patients. The mean recovery rate was 58.2% with the mJOA score; mean pre- and postoperative NRS scores were 7.4 and 2.3, respectively. The mean operative time was 77.6 min. Although there were no major complications, pain did not improve in an 80-year-old woman with coexisting spondylolisthesis (Meyerding grade 2). CONCLUSIONS: PETA using a full-endoscopic system is a safe and effective minimally invasive treatment for L5-LFS, with potential to be an alternative surgical strategy for L5-S1 interbody fusion.
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) is a relatively less invasive treatment for lumbar disc herniation (LDH). This study investigated the usefulness of a full-endoscopic system for PELD to treat L5 nerve root compression caused by lumbar foraminal stenosis (L5-LFS). METHODS: Between November 2016 and December 2017, a total of 10 patients with unilateral leg pain due to L5-LFS underwent surgery using a full-endoscopic system for PELD. Patients with bilateral L5-LFS or L5-LFS with coexisting LDH and/or spondylolysis were excluded from this study. A percutaneous endoscopic translaminar approach (PETA) was performed via the ipsilateral vertebral isthmus using a 3.5-mm diameter high-speed drill. Preoperative and postoperative statuses were evaluated using the modified Japanese Orthopedic Association (mJOA) and Numerical Rating Scale (NRS) scores. RESULTS: The patients' mean age was 62.2 years; there were 7 male and 3 female patients. The mean recovery rate was 58.2% with the mJOA score; mean pre- and postoperative NRS scores were 7.4 and 2.3, respectively. The mean operative time was 77.6 min. Although there were no major complications, pain did not improve in an 80-year-old woman with coexisting spondylolisthesis (Meyerding grade 2). CONCLUSIONS: PETA using a full-endoscopic system is a safe and effective minimally invasive treatment for L5-LFS, with potential to be an alternative surgical strategy for L5-S1 interbody fusion.
Authors: Gökalp Silav; Mehmet Arslan; Ayhan Comert; Halil I Acar; Gökmen Kahilogullari; Habibullah Dolgun; Richard S Tubbs; Ibrahim Tekdemir Journal: J Neurosurg Sci Date: 2016-09 Impact factor: 2.279
Authors: Joseph A Sclafani; Kamshad Raiszadeh; Ramin Raiszadeh; Paul Kim; Todd Doerr; Farhan Siddiqi; Ivan LaMotta; Paul Park; Cary Templin; Sandeep Gill; Kevin Liang; Choll W Kim Journal: Int J Spine Surg Date: 2014-12-01