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Endoscopic percutaneous transforaminal treatment for herniated lumbar discs
S Eustacchio1, G Flaschka, M Trummer
1Department of Neurosurgery, Karl-Franzens University, Graz, Austria.
Acta Neurochirurgica
|October 17, 2002
Summary
Endoscopic percutaneous transforaminal discectomy offers an effective alternative for herniated lumbar discs, achieving good clinical outcomes with minimal invasivity. This procedure shows promise in reducing the need for open surgery in select patients.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
- Spinal Endoscopy
Background:
- Percutaneous treatments for herniated lumbar discs often yield suboptimal results compared to microsurgery.
- Endoscopic techniques are being explored to improve outcomes for these conditions.
Purpose of the Study:
- To evaluate the clinical outcomes and complication rates of endoscopic percutaneous transforaminal discectomy.
- To assess the efficacy of this minimally invasive approach for extruded or sequestrated herniated lumbar discs.
Main Methods:
- A cohort of 122 patients (86 male, 36 female) underwent endoscopic treatment for herniated lumbar discs.
- Follow-up assessments included neurological controls and clinical reassessment using the Macnab scale and Prolo outcome score over a median of 35 months.
Main Results:
- Endoscopic treatment alone resulted in permanently improved or normal clinical status in 96 patients (78.7%).
- Two patients experienced spinal nerve root injury, with no additional neurological deficits or worsening of pre-existing conditions.
- 26 patients required subsequent conventional microsurgical interventions.
Conclusions:
- Endoscopic percutaneous transforaminal discectomy demonstrates minimal invasivity, good functional outcomes, and a low complication rate (1.6%).
- This procedure is an attractive alternative for foraminal and extraforaminal herniated lumbar discs, potentially reducing the need for open surgery in selected cases.