Transforaminal endoscopic lumbar discectomy (TELD) with the outside-in technique can be applied to nearly all cases of lumbar disc herniation (LDH), and transpedicular endoscopic lumbar discectomy can be used to treat highly migrated LDHs. The purpose of this study was to outline these 2 outside-in surgical techniques and to present their clinical outcomes. Between January 2018 and January 2019, a total of 137 patients underwent either transforaminal or transpedicular endoscopic lumbar discectomy. We performed TELD in 124 patients and transpedicular endoscopic lumbar discectomy in 13 cases. All surgical procedures were performed under conscious sedation. The patients' mean age was 51.3 years; 51 were women and 86 were men. The overall disc recurrence rate was 5.12%. Visual analogue scale scores decreased significantly in both groups. According to the MacNab criteria, good and excellent results were obtained in 92.74% of patients after transforaminal and in 92.30% of patients after transpedicular endoscopic LDH treatment. The results suggest that TELD with the outside-in technique can be effective for the treatment of most cases of LDH. Transpedicular endoscopic lumbar discectomy can be considered as an alternative treatment for highly migrated LDH.
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http://dx.doi.org/10.14245/ns.2040128.064 | DOI Listing |
Oper Neurosurg (Hagerstown)
January 2025
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Sci Rep
January 2025
Department of Neurosurgery, Seoul National University Hospital, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Lumbar foraminal stenosis can be surgically treated by foraminal decompression or facet joint resection and fusion (transforaminal lumbar interbody fusion, TLIF). While conventional foraminal decompression poses a risk of segmental instability, the endoscopic approach (extended endoscopic lumbar foraminotomy, EELF) resects only the ventral part of the facet joint with a horizontal surgical trajectory. A prospective observational study was performed to analyze the cost-effectiveness of EELF versus TLIF.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Spine Surgery, Binzhou Medical University Hospital, No. 661, Huanghe Er Road, Binzhou, 256603, Shandong, China.
Background: One-hole split endoscopy (OSE) is a novel endoscopic technique that offers some advantages in spinal surgery. However, without a clear understanding of the safe zone for OSE, surgeons risk injuring nerve roots during the procedure. This study aimed to measure the safe distances among critical bone markers, the intervertebral space and nerve roots between 1-degree degenerative lumbar spondylolisthesis (DLS) and non-DLS at the L segment in patients via three-dimensional reconstruction and to compare the differences in relevant safety distances between the two groups.
View Article and Find Full Text PDFGlobal Spine J
January 2025
Research & Development, Endospine SLU, Andorra la Vella, Andorra.
Study Design: Exploratory prospective observational case-control study.
Objectives: Aim of this study was to compare clinical and radiologic outcome, as well as peri-operative complications, of anterior lumbar interbody fusion (ALIF) and full-endoscopic/percutaneous trans-Kambin transforaminal lumbar interbody fusion (pTLIF) with a large-footprint interbody cage.
Methods: Patients that underwent elective ALIF and pTLIF with a large-footprint interbody cage were prospectively evaluated.
Orthop Surg
January 2025
Department of Spine Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, People's Republic of China.
Objective: Unilateral biportal endoscopic discectomy (UBE) is an emerging and minimally invasive surgeryfor lumbar spinal degenerative disease. However, the efficacy, safety and the radiological changes of dural sac and paraspinal muscle of UBE compared with the conventional percutaneous transforaminal endoscopic discectomy (PTED) remains to be determined. The purpose of the study was to comprehensively compare the clinical efficacy between UBE and PTED in the surgical treatment of lumbar spinal degenerative disease.
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