Hao Wang1,2, Tianyao Zhou1,2, Yutong Gu3,4, Zuoqin Yan5. 1. Department of Orthopaedic Surgery, Zhongshan Hospital Fudan University, 200032, Shanghai, China. 2. Shanghai Medical College, Fudan University, 200032, Shanghai, China. 3. Department of Orthopaedic Surgery, Zhongshan Hospital Fudan University, 200032, Shanghai, China. 447574313@qq.com. 4. Department of Orthopaedic Surgery, Shanghai Public Health Clinical Center, Fudan University, 201508, Shanghai, China. 447574313@qq.com. 5. Department of Orthopaedic Surgery, Zhongshan Hospital Fudan University, 200032, Shanghai, China. yan.zuoqin@zs-hospital.sh.cn.
Abstract
BACKGROUND: Percutaneous transforaminal endoscopy has been widely used to treat lumbar disc herniation (LDH), but the steep learning curve and difficulties in removing the calcified disc hinders the application of conventional endoscopy in treating calcified lumbar disc herniation (CLDH). In 2017, we first reported Percutaneous Transforaminal Endoscopic Surgery (PTES) as an easy-to-learn posterolateral transforaminal endoscopic technique to decompress the nerve root for LDH. We used our PTES technique to remove the calcified LDH and the purpose of this study is to evaluate the safety and efficacy of this technique. METHODS: Forty-six patients with CLDH and fifty-five patients with uncalcified lumbar disc herniation (ULDH) underwent PTES to decompress the nerve root. Visual analogue scale was collected before the surgery, immediately, one week, one month, two months, three months, six months, 12 months and 24 months after surgery. The outcomes of MacNab classification were collected 24 months after surgery. Intra- and Post-operative complications were also recorded. RESULTS: For CLDH patients, the VAS score was 9 (5-10) before operation, and then dropped to 2 (1-4) after surgery. VAS score continually decreased to 0 (0-3) at 24 months after surgery. 95.65% of CLDH patients showed excellent or good outcomes. ULDH group showed similar MacNab classification (94.55%) and VAS changing curve. The therapeutic effect of PTES in treating CLDH was as good as that in treating uncalcified patients. CONCLUSIONS: PTES is an effective and safe method to treat calcified lumbar disc herniation.
BACKGROUND: Percutaneous transforaminal endoscopy has been widely used to treat lumbar disc herniation (LDH), but the steep learning curve and difficulties in removing the calcified disc hinders the application of conventional endoscopy in treating calcified lumbar disc herniation (CLDH). In 2017, we first reported Percutaneous Transforaminal Endoscopic Surgery (PTES) as an easy-to-learn posterolateral transforaminal endoscopic technique to decompress the nerve root for LDH. We used our PTES technique to remove the calcified LDH and the purpose of this study is to evaluate the safety and efficacy of this technique. METHODS: Forty-six patients with CLDH and fifty-five patients with uncalcified lumbar disc herniation (ULDH) underwent PTES to decompress the nerve root. Visual analogue scale was collected before the surgery, immediately, one week, one month, two months, three months, six months, 12 months and 24 months after surgery. The outcomes of MacNab classification were collected 24 months after surgery. Intra- and Post-operative complications were also recorded. RESULTS: For CLDH patients, the VAS score was 9 (5-10) before operation, and then dropped to 2 (1-4) after surgery. VAS score continually decreased to 0 (0-3) at 24 months after surgery. 95.65% of CLDH patients showed excellent or good outcomes. ULDH group showed similar MacNab classification (94.55%) and VAS changing curve. The therapeutic effect of PTES in treating CLDH was as good as that in treating uncalcified patients. CONCLUSIONS: PTES is an effective and safe method to treat calcified lumbar disc herniation.
Authors: Daniëlle Awm van der Windt; Emmanuel Simons; Ingrid I Riphagen; Carlo Ammendolia; Arianne P Verhagen; Mark Laslett; Walter Devillé; Rick A Deyo; Lex M Bouter; Henrica Cw de Vet; Bert Aertgeerts Journal: Cochrane Database Syst Rev Date: 2010-02-17