EFFICACY OF FULL-ENDOSCOPIC INTERLAMINAR AND TRANSFORAMINAL DISCECTOMY FOR LUMBER DISC HERNIATION.

IF 0.5 4区医学 Q4 ORTHOPEDICS Acta Ortopedica Brasileira Pub Date : 2023-10-23 eCollection Date: 2023-01-01 DOI:10.1590/1413-785220233105e263326

Guoqiang Zhang, Xuehu Xie, Ning Liu

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Abstract

A previous study has reported the therapeutic effects of interlaminar/transforaminal approaches under full-endoscopic visualization to treat L5-S1 lumber disc herniation (LDH). However, the comparison of interlaminar/transforaminal approaches to treat other segments of LDH remains unclear.

Objective: To evaluate the clinical efficacy of full-endoscopic interlaminar and transforaminal lumbar discectomy to treat LDH.

Methods: A total of 93 patients with LDH who underwent fully-endoscopic lumbar interlaminar/transforaminal discectomy were retrospectively collected. Patients were divided into a Transforaminal group (n=41) and an Interlaminar group (n=52). Clinical efficacy was evaluated by visual analogue scale (VAS), the Oswestry disability index (ODI), and the modified MacNab scoring system.

Results: Of the 93 patients, involving segments in LDH referred to L_3-4, L_4-5, and L_5-S1. The fluoroscopy times in the Interlaminar group were smaller than that of the Transforaminal group. We found no obvious significances between the Transforaminal and Interlaminar groups regarding operation time, incision length, postoperative landing time, hospitalization, and incision healing time. Postoperative VAS and ODI scores notably improved at follow-up. Besides, almost 90% LDH patients achieved excellent/good outcomes.

Conclusion: The full-endoscopic visualization technique via interlaminar and transforaminal approaches safely and effectively treat LDH. Level of Evidence III, Retrospective Study.

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全内窥镜椎间和椎间孔椎间盘切除术治疗腰椎间盘突出症的疗效。

先前的一项研究报道了在全内窥镜下经椎间孔/椎间孔入路治疗L5-S1腰椎间盘突出症（LDH）的疗效。然而，层间/经孔入路治疗LDH其他节段的比较尚不清楚。目的：评价全内镜下椎间盘间和椎间孔间切除术治疗腰椎间盘突出症的临床疗效。患者被分为经孔组（n=41）和层间组（n=52）。通过视觉模拟量表（VAS）、奥斯韦斯特里残疾指数（ODI）和改良的MacNab评分系统评估临床疗效。结果：在93例患者中，涉及LDH的节段分别为L3-4、L4-5和L5-S1。层间组的荧光检查次数小于经孔组。我们发现经孔组和层间组在手术时间、切口长度、术后落地时间、住院时间和切口愈合时间方面没有明显意义。术后VAS和ODI评分在随访中显著改善。此外，近90%的LDH患者取得了良好的结果。结论：经椎间孔和椎间孔入路的全内镜可视化技术安全有效地治疗LDH。证据水平III，回顾性研究。

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来源期刊

Acta Ortopedica Brasileira Orthopedics-

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

25 weeks

期刊介绍： A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.