The technique and efficacy of percutaneous transforaminal endoscopic surgery for surgical treatment of L5/S1 disc herniation
10.12025/j.issn.1008-6358.2017.20170060
- VernacularTitle:PTES椎间孔镜技术治疗腰5/骶1椎间盘突出症的技巧及疗效
- Author:
Yu-Tong GU
1
;
De-Rong L(U)
;
Zhan CUI
;
Zuo-Qing LIU
;
Xiao-Gang ZHOU
;
Zhen-Zhou FENG
;
Jian DONG
;
Xiao-Xing JIANG
;
Yun YE
Author Information
1. 复旦大学附属中山医院骨科
- Keywords:
lumbar disc herniation;
percutaneous endoscopic lumbar discectomy;
transforaminal;
L5/S1;
iliac crest
- From:
Chinese Journal of Clinical Medicine
2017;24(4):497-503
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the technique and efficacy of PTES for treatment of L5/S1 disc herniation.Methods:PTES was performed on 52 cases of L5/S1 herniations without spinal instability and central spinal canal stenosis,including 24 cases of high iliac crest,from November 2012 to April 2013.The operation duration,frequency of intraoperative fluoroscopy,blood loss and hospitalization days were recorded.Leg pain was evaluated by using the visual analog scale(VAS)Preoperatively and immediately,1 week,1 month,2 months,3 months,6 months,1 year and 2 years after surgery.The results were determined to be excellent,good,fair,or poor according to the Macnab classification,and complications were observed at 2-year follow-up.Objective:The mean operation duration was(56.3 ±11.5)min per segment.The median frequency of intraoperatively fluoroscopy was 5(3-14)times.The median blood loss was 5(2-20)mL.The median hospital stay was 3(2-4)days.The average postoperative follow-up was(26.2±2.0)months.The median preoperative VAS score of leg pain was 9(6-10),1(0-3)immediately after the operation and 0(0-3)2 years after operation,and the differences were statistically significant(P<0.001).There were 3 cases of lower limb rebound pain 1 week after operation,which were relieved within 2 months after operation.The rate of excellent and good curative effect was 98.1％(51/52)2 years after operation.No complications such as nerve injury,infection,abdominal organ damage and rupture of large vessels occurred.No recurrence occurred.Conclusions:PTES for L5/S1 disc herniation including the cases with high iliac crest is an easy,effective and safe technique.The method has the advantages of simple positioning,easy puncture,simple steps and less fluoroscopy,and the learning curve is not steep for surgeons.
