Percutaneous Endoscopic Lumbar Discectomy for Axillar Herniation at L5-S1 via the Transforaminal Approach Versus the Interlaminar Approach: A Prospective Clinical Trial.

Percutaneous Endoscopic Lumbar Discectomy for Axillar Herniation at L5-S1 via the Transforaminal Approach Versus the Interlaminar Approach: A Prospective Clinical Trial.

World Neurosurg. 2019 Jan 30;:

Authors: Mo X, Shen J, Jiang W, Zhang X, Zhou N, Wang Y, Hao J

Abstract
OBJECTIVE: To evaluate the results of percutaneous endoscopic transforaminal discectomy (PETD) in comparison with percutaneous endoscopic interlaminar discectomy (PEID) for axillar herniation at L5-S1.
METHODS: From January 2017 to March 2018, 80 patients admitted with axillar herniation at L5-S1 were randomly recruited into two groups: 40 cases in the PETD group and 40 in the PEID group. Each group separately underwent PETD or PEID. Patient sex, age, body mass index (BMI), axillar herniation size, number of C-arm fluoroscopies, operation time, postoperative bed time, complications, and clinical effect were compared. Both groups were followed up using the Oswestry Disability Index (ODI), visual analogue scale (VAS) and MacNab criteria.
RESULTS: Except for one case in the PETD group that switched to the PEID group, the patients completed the study as expected. All patients were followed up. Preoperative demographics were not significantly different (P > 0.05) between the two groups. The mean number of C-arm fluoroscopies (12.44 ± 3.21) and the operation time (66.49 ± 16.29 minutes)of PETD group were significantly improved compared with the PEID group (number of fluoroscopies: 3.41 ± 0.81, P < 0.001; operation time: 53.56 ± 10.82 minutes, P < 0.001), but the postoperative bed rest time and complication rate were not (P > 0.05). The postoperative ODI and VAS scores were obviously improved in both groups when compared with preoperation (P < 0.001). There were no significant differences between the 2 groups in MacNab criteria or VAS and ODI scores at the same time point (P > 0.05).
CONCLUSIONS: For axillar herniation at L5-S1, PEID can ignore the anatomic obstruction with advantages including a shorter operation time and less intraoperative radiation exposure. PETD has a clinical effect similar to that of PEID, but the process of it is more dangerous and harder than PEID.

PMID: 30710722 [PubMed - as supplied by publisher]

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