Transforaminal endoscopic microdiscectomy in the treatment of patients with herniated intervertebral discs in the lumbar spine
DOI:
https://doi.org/10.25305/unj.318996Keywords:
transforaminal endoscopic microdiscectomy, minimally invasive treatment methods, outpatient neurosurgeryAbstract
More than 800,000 microdiscectomies are performed annually worldwide. According to various authors, good and excellent results are about 85%, with adequate selection of patients for surgical treatment. Nevertheless, up to 40% of patients continue to suffer from pain, motor and sensory disorders, although their intensity decreases after surgery. Therefore, the search for new methods of surgical interventions that will improve the results of treatment of such patients continues.
In the late 90s of the last century, the JOIMAX company (Germany) developed a technique for endoscopic transforaminal microdiscectomy, which used a lateral (transforaminal) rather than a standard interlaminar approach. According to literature data, endoscopic transforaminal microdiscectomy has up to 93% of positive outcomes.
Objective. To study the immediate and long-term outcomes of treatment of patients with herniated intervertebral discs in the lumbar spine using the transforaminal endoscopic microdiscectomy method.
Materials and methods. The immediate (1st day after surgery) and long-term (6th month postoperatively) outcomes of surgical treatment of 68 patients with herniated intervertebral discs in the lumbar spine were studied. Patients were operated on using the endoscopic transforaminal microdiscectomy method at the «Family Medicine Clinic», Dnipro from 2020 to 2024.
Results. There were 52 men and 16 women, the age of the patients ranged from 24 to 68 years (average 44.2 years), the duration of the disease was from 6 months to 12 years. Before the operation, the average pain score according to VAS was 8.7 points. Pain syndrome on the VAS scale on the 1st day after surgery was, on average, 3.5 points, after 6 months - 3 points. After 6 months after surgery, 63 patients (93%) had good treatment outcomes according to the J. MacNab scale. Unsatisfactory results were in 5 patients (7%).
Conclusions. Transforaminal endoscopic microdiscectomy is a modern highly effective minimally invasive method of surgical treatment of herniated intervertebral discs in the lumbar spine, which allows to significantly reduce intraoperative trauma, the patient’s hospital stay, accelerate the rehabilitation of patients, and improve treatment outcomes.
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