Percutaneous Endoscopic Lumbar Discectomy for Huge Lumbar Disc Herniation with Complete Dural Sac Stenosis via an Interlaminar Approach: An Observational Retrospective Cohort Study
Cheng Ma,1,* He Li,1,* Yifan Wei,1 Lijia Liu,1 Yin Shi,2 Yongxin Ren1 1Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, People’s Republic of China; 2Department of Radiology, The First Affiliated Hospital of Nanjing Med...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2021
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| Acceso en línea: | https://doaj.org/article/aaf03d0a170c4ea8a981c35e47cf9050 |
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| Sumario: | Cheng Ma,1,* He Li,1,* Yifan Wei,1 Lijia Liu,1 Yin Shi,2 Yongxin Ren1 1Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, People’s Republic of China; 2Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongxin Ren; Yin Shi Tel +86 13585162283Email renyongxinjsph@163.com; shiyin_njmu@foxmail.comPurpose: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive spinal surgery for huge lumbar disc herniation (HLDH). The aim of this study was to investigate the short-term clinical effectiveness of PELD for HLDH with complete dural sac stenosis via an interlaminar approach.Methods: We retrospectively analyzed 56 patients diagnosed with HLDH with complete dural sac stenosis and treated with PELD via an interlaminar approach. Numerical rating scale (NRS), Oswestry disability index (ODI), and modified Japanese orthopedic association (mJOA) were used to evaluate preoperative conditions as well as outcomes at 1, 3, 6 and 12 months postoperatively. At the final follow-up, the clinical effects were evaluated using modified MacNab criteria.Results: All patients were followed for at least 12 months. At 1, 3, 6, and 12 months postoperatively, the NRS and ODI scores were significantly decreased, and the mJOA score significantly increased compared with preoperative results (P< 0.001). According to the Macnab criteria at the final follow-up, it was excellent in 42 patients (75%), good in 9 (16.1%), and fair in 5 (8.9%). The overall clinical satisfactory rate was 91.1%.Conclusion: Our study results suggest that percutaneous endoscopic interlaminar discectomy (PEID) is available for the treatment of HLDH with complete dural sac stenosis, whose benefits are rapid recovery, complete removal of the herniated disc, effective spinal canal decompression, fewer complications, and significant relief of clinical symptoms.Keywords: percutaneous endoscopic lumbar discectomy, percutaneous endoscopic interlaminar discectomy, huge lumbar disc herniation, complete dural sac stenosis, diffusion tensor imaging |
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