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Published on: October 14, 2022
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Percutaneous Endoscopic Discectomy Via a Transforaminal Approach for L5/S1 Far-Lateral Disc Herniation Assisted by
Bing Ran1, Rong Chen2, Chanchan Song2
1Suzhou Medical College of Soochow University, Suzhou, China; Pain Department, GanNan Medical University, GanZhou, China; First Affiliated Hospital of GanNan Medical University, GanZhou, China.
World Neurosurgery
|August 4, 2022
Summary
Percutaneous lumbar transforaminal endoscopic discectomy (PTED) with intraoperative computed tomography (iCT) navigation is a safe and effective treatment for L5-S1 far-lateral lumbar disc herniation (LDH). This minimally invasive approach significantly improves patient pain and function.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
- Spinal Imaging
Background:
- Far-lateral lumbar disc herniation (LDH) at the L5-S1 level presents unique surgical challenges.
- Traditional surgical approaches may involve significant tissue disruption.
Purpose of the Study:
- To evaluate the clinical outcomes of percutaneous lumbar transforaminal endoscopic discectomy (PTED) guided by intraoperative computed tomography (iCT) navigation.
- To assess the efficacy of this minimally invasive technique for L5-S1 far-lateral LDH.
Main Methods:
- A prospective study of 30 patients with L5-S1 far-lateral LDH treated with PTED and iCT navigation.
- Clinical outcomes were measured using validated scores including VAS, ODI, JOA, EQ-5D-5L, and Macnab criteria.
- Preoperative and postoperative complications were systematically recorded.
Main Results:
- Significant improvements were observed in leg pain (VAS), disability (ODI), and functional scores (JOA) postoperatively (P < 0.01).
- Patient-reported quality of life (EQ-5D-5L) substantially increased, with 93% achieving good or excellent outcomes (Macnab criteria) at 12 months.
- Combined L5-S1 foraminal stenosis was associated with poorer outcomes and increased need for further treatment.
Conclusions:
- Percutaneous lumbar transforaminal endoscopic discectomy (PTED) with iCT navigation is a feasible and effective minimally invasive surgical option for L5-S1 far-lateral lumbar disc herniation.
- This technique offers significant clinical benefits and high patient satisfaction.
