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A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
[Comparative study of treating recurrent lumbar disc protrusion by three different surgical procedures]
Xianglong Zhuo1, Jianzhong Hu, Bing Li
1Department of Spinal Surgery, the People's Hospital of Liuzhou, Liuzhou Guangxi, 545006, P.R. China. karl_zhuo@126.com
Summary
Transforaminal lumbar interbody fusion (TLIF) is a safer and more effective treatment for recurrent lumbar disc protrusion (RLDP) compared to conventional discectomy and posterior lumbar interbody fusion (PLIF). While all methods show effectiveness, TLIF results in fewer complications and better outcomes.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Recurrent lumbar disc protrusion (RLDP) presents a significant clinical challenge.
- Various surgical interventions aim to address RLDP, each with potential benefits and drawbacks.
Purpose of the Study:
- To compare the therapeutic efficacy of conventional discectomy, posterior lumbar interbody fusion (PLIF), and transforaminal lumbar interbody fusion (TLIF) for treating RLDP.
Main Methods:
- A cohort of 65 patients with single-level RLDP were surgically treated between 2000 and 2008.
- Patients were divided into three groups: conventional discectomy (25), PLIF (22), and TLIF (18).
- Outcomes were assessed based on perioperative complications, operation time, blood loss, hospitalization, patient satisfaction, fusion rates, visual analogue scale (VAS), Oswestry disability index (ODI), and intervertebral space height (ISH).
Main Results:
- TLIF demonstrated a significantly lower incidence of perioperative complications (5.6%) compared to conventional discectomy (24.0%) and PLIF (22.3%).
- Conventional discectomy led to a significant reduction in intervertebral space height (ISH), potentially causing segment instability.
- All procedures showed significant improvement in VAS and ODI scores, with no significant differences in improvement rates among the groups.
Conclusions:
- Conventional discectomy, PLIF, and TLIF are all effective for RLDP.
- TLIF is associated with fewer complications and is considered a safer, more effective option for RLDP treatment.
- Conventional discectomy may lead to further intervertebral space narrowing and instability.