Comparison of Two Minimally Invasive Techniques with Endoscopy and Microscopy for Extraforaminal Disc Herniations

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Küçük Resim

Tarih

2020

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

Elsevier Science Inc

Erişim Hakkı

info:eu-repo/semantics/closedAccess

Özet

OBJECTIVE: Extraforaminal disc herniations ate, extraordinary herniations because they are located outside the foraminal bony borders and compress the root exiting at the corresponding level, whereas in median or paramedian herniations, the root 1 level below is compressed. Percutaneous endoscopic discectomy (PED) and microscopic extraforaminal discectomy (MEFD) are 2 popular contemporary techniques that have been performed extensively for these herniations since the 1970s. METHODS: In this study, we retrospectively analyzed 118 patients who underwent either PED (66 patients) or MEFD (52 patients). All the patients were clinically evaluated for neurologic examination findings, visual analog scale (VAS) scores for leg pain and Oswestry Disability Index (ODI) preoperatively and on the seventh postoperative day as well as 6 and 12 months after surgery. The complication rates and types of both techniques were discussed. RESULTS: The preoperative VAS score and ODI were all comparable. Improvements in VAS scores 6 months postoperatively and improvements in ODI at all follow-up periods were statistically significant in favor of PED. However, there was great discrepancy regarding the postsurgical complications in favor of MEFD. CONCLUSIONS: PED is more prone to complications because this technique is strictly dependent on the tubular system and the ideal anatomy of the Kambin triangle. Variations in or degeneration of the Kambin triangle can lead to devastating complications in the PED technique, but normal anatomic conditions are feasible in only approximately 20% of patients. The most important feature of this study was that both techniques were performed by the same experienced team, who developed their own concept.

Açıklama

Anahtar Kelimeler

Complications of lumbar discectomy, Endoscopic discectomy, Extraforaminal disc herniations, Foraminal disc herniations, Kambin triangle, Lateral disc herniation, Lumbar discectomy, Lumbar Interbody Fusion, Interlaminar Approach, Surgical-Management, Peridural Fibrosis, Diskectomy, Surgery, Instability, Pain, Spondylolisthesis, Complications

Kaynak

World Neurosurgery

WoS Q Değeri

Q3

Scopus Q Değeri

Q2

Cilt

144

Sayı

Künye