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Journal of Neurosurgical Sciences 2018 Mar 26

DOI: 10.23736/S0390-5616.18.04395-3


language: English

Transforaminal percutaneous endoscopic lumbar discectomy: outcome and complications in 270 cases

Leonello TACCONI 1 , Sara BALDO 1, Giorgio MERCI 2, Gerardo SERRA 2

1 Neurosurgical Unit, Azienda Sanitaria Universitaria Integrata, Trieste, Italy; 2 Anesthesia and Analgesic Therapy Department, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy


BACKGROUND: The endoscopic approach has been introduced in the clinical practice in 1980 with the aim to remove the pro- lapsed disk and free the compressed nerve using the least disruptive surgical technique, assuring in the same time, the resolution of the symptoms and a faster return back to normal life activity. Over the years, thanks to an extraordinary technical improvement either in terms of quality of images and development of many dif- ferent tailored instrumentations there has been a huge spreading of the endoscope use across the different surgical fields. For this reasons the transforaminal percutaneous endoscopic lumbar discectomy can be con- sidered, at the moment, the least invasive procedure for the removal of lumbar disc prolapsed. The aim of this study was to analyze the clinical outcome and complications rate on a large cumulative series operated on in two years period.
METHODS: We present a retrospective series involving 270 cases of lumbar disk herniation managed surgically only by a percutaneous transforaminal endoscopic technique in two units and by two surgeons. All patients have a minimum follow-up of 6 months. Primary study end-points were evaluation of out- comes using the Visual Analogue Scale and Oswestri Disability Index pre-operatively and at 3, 6 and 12 month as well as the complications and the recurrence rates.
RESULTS: Our results, with a positive outcome around 93%, confirm the effectiveness of transforaminal per- cutaneous endoscopic discectomy in the treatment of lumbar disc herniation when compare to open microdiscectomy. Also the complications (5,5%) and the recurrence rate (4,1%) can be considered within the standard results.
CONCLUSIONS: The transforaminal percutaneous endoscopic lumbar discectomy is a safe and effective procedure to treat lumbar disc prolapsed. Surgical experience and correct patients’ selection are crucial factors affecting the outcome.

KEY WORDS: Endoscope - Transforaminal approach - Disk prolapsed - Infection - Recurrence rate

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