Full-Endoscopic Lumbar Discectomy for Lumbar Disc Herniation with Posterior Ring Apophysis Fracture: a Retrospective Study.

Full-Endoscopic Lumbar Discectomy for Lumbar Disc Herniation with Posterior Ring Apophysis Fracture: a Retrospective Study.

World Neurosurg. 2018 Dec 24;:

Authors: Zheng ZZ, Tu Z, Li Y, Dai Y, Wu PF, Jiang B, Xu J, Xiao S, Li L, Lv GH, Wang B

Abstract
OBJECTIVE: This retrospective study attempted to evaluate the clinical results of full-endoscopic lumbar discectomy (FELD) for the treatment of lumbar disc herniation (LDH) with lumbar posterior ring apophysis fracture (PRAF) via the interlaminar (IL) or transforaminal(TF) approach.
STUDY DESIGN: Retrospective study.
SETTING: Inpatient surgery center METHODS: A series of single-level LDH with Type III PRAF patients who underwent FELD via an IL or TF approach between January 2010 and December 2015 was enrolled. General data included sex, age, location, surgical approach, operative time, hospital stay, perioperative complications and recurrences. Classification of mobile fragment and immobile fragment were documented. Clinical outcomes were evaluated using a visual analog scale (VAS) for low back and leg pain; Oswestry Disability Index (ODI) was employed for functional assessment and modified Macnab criteria for patient satisfaction.
RESULTS: FELD was performed successfully in all cases and no serious perioperative complications were observed. The mobile fragment of PRAS existed in 18 patients and immobile fragment in 15 patients. Complication rate was 2/33 including one dual tear (3.0%）and one transient dysesthesia (3.0%）that did not receive further treatment. Recurrence was found in one patient (3.0%）and required reoperation. The VAS and ODI were significantly improved postoperative at 3, 6, 12 months and final follow-up (P < 0.05). An excellent/good rate of 93.4 % was achieved according to modified Macnab criteria.
CONCLUSIONS: FELD is a safe and effective minimally invasive approach for the treatment of LDH with Type III PRAF. Sufficient preparation and experience is required to get satisfied results.

PMID: 30590214 [PubMed - as supplied by publisher]

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