Percutaneous Transforaminal Endoscopic Spine System in Lumbar Discectomy for Disc Herniation / 天津医药

ABSTRACT

Objective To investigate the value of percutaneous transforaminal endoscopic spine system (TESSYS) in lumbar discectomy for disc herniation. Methods Thirty one patients with lumbar disc herniation were treated with TES-SYS and followed up 6-12 months. The involved levels of vertebral segment included L34 (2 cases), L45 (21 cases) and L5S1 (8 cases). The targeted puncture was performed under local anesthesia and fluoroscopic guidance. The foramen of involved level of vertebral segment was enlarged gradually with four trephinations, and the working cannula was inserted transforaminal in-to the canal. Then the herniation was exposed and removed with full endoscopic technique, including the loosen nucleus pulposus. The nerve root and dural sac were exposed and released adequately. Results The procedure was evenly carried out in 27 cases. After discectomy, the nerve roots were complete released, and not exposed in the first case of far lateral herni-ation and the second case of central herniation. The third case and eleventh case converted to microendoscopic discectomy, due to large herniation and intraoperative pain, respectively. The patients could walk in the same day, 1 or 2 days after opera-tion, with obvious relief of leg pain. One case of recurrence was found at 2 weeks after operation, who was treated conserva-tively. At the final follow-up, the visual analogue scale of leg pain decreased from 8.1±1.9 to 1.1±0.9, and the Oswestry dis-ability index (ODI) decreased from 31.1±8.3 to 3.4±3.3. According to MacNab scale, there were excellent results in 25 cases and good results in 6 cases. Conclusion The percutaneous endoscopic TESSYS is a good minimal invasive technique for lumbar discectomy, with good results and a learning curve.