DOI: https://doi.org/10.25305/unj.47496

The comparative assessment of efficacy of endoscopic transforaminal microdiscectomy and open microdiscectomy in treatment of lumbar discs herniation

Mykola Zorin, Yuriy Kirpa, Mykola Zorin Jr

Abstract


Introduction. Method of endoscopic transforaminal microdiscectomy (ETMDE) has it’s own supporters and opponents. We decided to compare efficacy of ETMDE and open microdiscectomy (MDE).

Materials and methods. We analyzed treatment results in two groups of patients, similar in age, disease duration, hernia localization and size, severity of pain and radiculopathy. In 60 patients (group 1) ETMDE was performed, in 60 (group 2) — MDE. the Short-term results were evaluated in the period from 1 to 30 days after surgery.

Results. Positive results were achieved in both groups, respectively, in 91.7 and 88.4% patients. However, early reoperations were performed significantly more often in group 1 — in 8.3% patients than in the group 2 — in 1.5%. In group 1 unsatisfactory results were due to hernias migration in cranial or caudal direction, in group 2 — due to hernias middle position. Rehabilitation terms after ETMDE was almost 3 times less than after MDE.

Conclusion. ETMDE technique with proper patients selection and adequate surgeon’s experience as effective as MDE. Worse outcomes were due to hernias migration in cranial or caudal direction, but rehabilitation terms in general, three times less than after MDE.


Keywords


lumbar spine; discs herniation; microsurgical discectomy; endoscopic transforaminal microdiscectomy

References


Zozulya Yua, Pedachenko EG, SLyn’ko Neirurgicheskoye lecheniye neyrokompressionnykh poyasnichno-kresttsovykh bolevykh sindromov [Surgical treatment of nuyrokompressive lumbosacral pain syndromes]. Kiev: UIPK EksOb; 2006. Russian.

Polischuk NYe, Slinko EI, Brinkach IS. [The surgical treatment assessment depending on the lower lumbar intervertebral disc hernias location]. Ukrainian Neurosurgical Journal. 2002;(4):82-90. Ukrainian.

Slin’ko EI, Verbov VV. [Ligament-sparing lumbar microdiscectomy. Results of clinical application of a technique]. Ukrainian Neurosurgical Journal. 2003;(1):54-62. Ukrainian.

Kambin P. Arthroscopic microdiscectomy. Baltimor: Urban A. Schwarzenberg; 1991.

Yeung AT, Savitz MH. Multilevel lumbar percutaneous endoscopic discectomy. J. Minim. Inv. Spin. Tech. 2001;12(1):116-119.

Iprenburg M, Godschalx A. Transforaminal endoscopic surgery in lumbar disc herniation in an economic crisis. — The TESSYS method. US Musculoskeletal Review. 2008;3:47-49.

Kim MJ, Lee HN, Jung ES, Son BG, Choi ES, Shin JH, Sung JK, Chi YC. Targeted percutaneous transforaminal endoscopic diskectomy in 295 patients: comparison with results of microscopic diskectomy. Surgical Neurology. 2007;68(6):623-631. [CrossRef] [PubMed]

Nellensteijn J, Ostelo R, Bartels R, Peul W, van Roven B, van Tulder M. Transforaminal endoscopic surgery for symptomatic lumbar disc herniations: a systematic review of the literature. Eur. Spine J. 2010;19(2):181-204. [CrossRef] [PubMed]

Jasper GP, Francisco GM, Telfeian AE. A retrospective evaluation of the clinical success of transforaminal endoscopic discectomy with foraminotomy in geriatric. Patients Pain Phys. 2013;16(3):225-229. [PubMed]

Morgenstein R. Transforaminal endoscopic stenosis surgery (TESS). In: Abstracts of 27 International Course for Percutaneous Endoscopic Spinal Surgery and Complementary Minimal Invasive Techiques. Karsruhe, 2009. p.117-121.

Schubert M, Helmbrecht A, Schultz C, Wagner C. Endoscopic transforaminal discectomy. In: Abstracts of 28 International Course for Percutaneous Endoscopic Spinal Surgery and Complementary Minimal Invasive Techiques. — Zurich, 2010. p.86-92.

Schubert M, Helmbrecht A, Schultz C, Wagner C. Endoscopic transforaminal discoplasty in disc degeneration and low back pain. In: ISASS13 Full Abstract Book. — Vancouver, 2013. p.191-201.

Hoogland T, van den Brekel-Dijkstra K, Schubert M, Miklitz B. Endoscopic transforaminal discectomyfor recurrent lumbar disc herniation. Spine. 2008;33(9):973-978. [CrossRef] [PubMed]


GOST Style Citations


1. Зозуля Ю.А. Хирургическое лечение нейрокомпрессионных пояснично-крестцовых болевых синдромов / Ю.А. Зозуля, Е.Г. Педаченко, Е.И. Слынько. — К.: УИПК «ЕксОб», 2006. — 348 с.

2. Полищук Н.Е. Анализ результатов хирургического лечения больных в зависимости от локализации грыж поясничных межпозвонковых дисков / Н.Е. Полищук, Е.И. Слынько, И.С. Бринкач // Український нейрохірургічний журнал. — 2002. — №4. — С.82–90.

3. Слынько Е.И. Микродискэктомия с сохранением желтой связки. Результаты применения методики / Е.И. Слынько, В.В. Вербов // Український нейрохірургічний журнал. — 2003. — №2. — С.54–62.

4. Kambin P. Arthroscopic microdiscectomy / P. Kambin. — Baltimor: Urban A. Schwarzenberg, 1991. — 264 p.

5. Yeung A.T. Multilevel lumbar percutaneous endoscopic discectomy / A.T. Yeung, M.H. Savitz // J. Minim. Inv. Spin. Tech. — 2001. — V.12, N1. — Р.116–119.

6. Iprenburg M. Transforaminal endoscopic surgery in lumbar disc herniation in an economic crisis. — The TESSYS method / M. Iprenburg, A. Godschalx // US Musculoskeletal Review. — 2008. — N3. — P.47–49.

7. Targeted percutaneous transforaminal endoscopic discectomy in 295 patients: Comparison with results of microscopic discectomy / M.J. Kim, H.N. Lee, E.S. Jang, B.G. Son, E.S. Choi, J.H. Shin, J.K. Sung, Y.C. Chi // Surg. Neurol. — 2007. — V.68, N6. — P.623–631.

8. Transforaminal endoscopic surgery for symptomatic lumbar disc herniations: a systematic review of the literature / J. Nellensteijn, R. Ostelo, R. Bartels, W. Peul, B. van Roven, M. van Tulder // Eur. Spine J. — 2010. — V.19, N2. — P.181–204.

9. Jasper G.P. A retrospective evaluation of the clinical success of transforaminal endoscopic discectomy with foraminotomy in geriatric / G.P. Jasper, G.M. Francisco, A.E. Telfeian // Patients Pain Phys. — 2013. — V.16. — P.225–229.

10. Morgenstein R. Transforaminal endoscopic stenosis surgery (TESS) / R. Morgenstein // Abstracts of 27 International Course for Percutaneous Endoscopic Spinal Surgery and Complementary Minimal Invasive Techiques. — Karsruhe, 2009. — P.117–121.

11. Endoscopic transforaminal discectomy / M. Schubert, A. Helmbrecht, C. Schultz, C. Wagner // Abstracts of 28 International Course for Percutaneous Endoscopic Spinal Surgery and Complementary Minimal Invasive Techiques. — Zurich, 2010. — P.86–92.

12. Endoscopic transforaminal discoplasty in disc degeneration and low back pain / M. Schubert, A. Helmbrecht, C. Schultz, C. Wagner // ISASS13 Full Abstract Book. — Vancouver, BC, 2013. — P.191–201.

13.  Endoscopic transforaminal discectomyfor recurrent lumbar disc herniation / T. Hoogland, K. van den Brekel-Dijkstra, M. Schubert, B. Miklitz // Spine. — 2008. — V.33, N9. — P.973–978.





Copyright (c) 2014 Mykola Zorin, Yuriy Kirpa, Mykola Zorin Jr

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.