Transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral and foraminal lumbar disc herniations

被引:134
作者
Lew, SM
Mehalic, TF
Fagone, KL
机构
[1] Univ Vermont, Div Neurosurg, Burlington, VT 05405 USA
[2] Maine Med Ctr, Div Neurosurg, Portland, ME 04102 USA
关键词
endoscopy; discectomy; intervertebral disc herniation; lumbar spine;
D O I
10.3171/spi.2001.94.2.0216
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. Far-lateral (extraforaminal) and foraminal disc herniations comprise up to 11% of all herniated intervertebral discs. Operative management can be technically difficult, and the optimum surgical treatment remains controversial. Accessing these lateral disc herniations endoscopically via a percutaneous transforaminal approach offers several theoretical advantages over the more traditional procedures. The object of this study was to assess the safety and efficacy of treat ing patients with far-lateral and foraminal disc herniations via a percutaneous transforaminal endoscopic approach. Methods. A retrospective analysis was performed of 47 consecutive patients who underwent surgery via this approach. All procedures were performed after induction of a local anesthetic on an outpatient basis. Outcome was measured with Macnab criteria and by determining a patient's return-to-work status. The median follow-up period was 18 months (range 4-51 months). Excellent or good outcome was obtained in 40 (85%) of 47 patients. Of the 38 patients working before the onset of symptoms, 34 (90%) returned to work. Five patients (11%) experienced poor outcomes and subsequently underwent open procedures at the same level. Of the 10 recipients of Workers' Compensation, Macnab criteria indicated a significantly worst outcome (70% excellent or good), but an excellent return-to-work status was maintained (90%). There were no complications. Conclusions. Transforaminal percutaneous endoscopic discectomy is safe and efficacious in the treatment of far-lateral and foraminal disc herniations.
引用
收藏
页码:216 / 220
页数:5
相关论文
共 26 条
[1]
SURGICAL-MANAGEMENT OF EXTREME LATERAL LUMBAR-DISK HERNIATIONS - REVIEW OF 138 CASES [J].
ABDULLAH, AF ;
WOLBER, PGH ;
WARFIELD, JR ;
GUNADI, IK .
NEUROSURGERY, 1988, 22 (04) :648-653
[2]
EXTREME-LATERAL LUMBAR-DISK HERNIATIONS - CLINICAL SYNDROME AND SPECIAL PROBLEMS OF DIAGNOSIS [J].
ABDULLAH, AF ;
DITTO, EW ;
BYRD, EB ;
WILLIAMS, R .
JOURNAL OF NEUROSURGERY, 1974, 41 (02) :229-234
[3]
REPORT OF A CONTROLLED CLINICAL-TRIAL COMPARING AUTOMATED PERCUTANEOUS LUMBAR DISKECTOMY AND MICRODISCECTOMY IN THE TREATMENT OF CONTAINED LUMBAR DISC HERNIATION [J].
CHATTERJEE, S ;
FOY, PM ;
FINDLAY, GF .
SPINE, 1995, 20 (06) :734-738
[4]
FAR LATERAL DISC HERNIATIONS TREATED BY MICROSCOPIC FRAGMENT EXCISION - TECHNIQUES AND RESULTS [J].
DARDEN, BV ;
WADE, JF ;
ALEXANDER, R ;
WOOD, KE ;
RHYNE, AL ;
HICKS, JR .
SPINE, 1995, 20 (13) :1500-1505
[5]
Endoscopic transforaminal lumbar discectomy and reconfiguration: A posterolateral approach into the spinal canal [J].
Ditsworth, DA .
SURGICAL NEUROLOGY, 1998, 49 (06) :588-597
[6]
SURGICAL-TREATMENT FOR THE FAR LATERAL HERNIATED LUMBAR DISC [J].
DONALDSON, WF ;
STAR, MJ ;
THORNE, RP .
SPINE, 1993, 18 (10) :1263-1267
[7]
EPSTEIN NE, 1995, J SPINAL DISORD, V8, P383
[8]
EVALUATION OF VARIED SURGICAL APPROACHES USED IN THE MANAGEMENT OF 170 FAR-LATERAL LUMBAR DISC HERNIATIONS - INDICATIONS AND RESULTS [J].
EPSTEIN, NE .
JOURNAL OF NEUROSURGERY, 1995, 83 (04) :648-656
[9]
Fankhauser H, 1987, Br J Neurosurg, V1, P111, DOI 10.3109/02688698709034347
[10]
LATERAL LUMBAR-DISK HERNIATIONS [J].
FAUST, SE ;
DUCKER, TB ;
VANHASSENT, JA .
JOURNAL OF SPINAL DISORDERS, 1992, 5 (01) :97-103