A retrospective study of 43 consecutive patients who underwent percutaneous endoscopic lumbar discectomy for recurrent disc herniation.
To evaluate the efﬁcacy of endoscopic discectomy for recurrent disc herniations and to determine the prognostic factors affecting surgical outcome.
Summary of Background Data
Repeated open discectomy with or without fusion has been the most common procedure for a recurrent lumbar disc herniation. There have been no reports published on the feasibility and prognostic factors of the endoscopic discectomy for recurrent disc herniation.
The objective of this study is to evaluate the eﬃcacy of the endoscopic technique, as applied to patients with foraminal and extraforaminal disc herniations, and to report the outcome and complications. A retrospective analysis was performed of 35 consecutive cases of foraminal and extraforaminal lumbar disc herniation managed by posterolateral endoscopic discectomy. Pain was measured by means of the Visual Analog Score. Patient satisfaction was evaluated by the Macnab outcome criteria. The median follow-up period was 18 months (range 10 to 35 months). The mean Visual Analog Score improved from 8.6 before the surgery to 3.2 after the surgery. Overall, excellent or good outcomes were obtained in 30 (85.7%) of the 35 patients at the last follow-up examination, with both these outcomes showing statistically signiﬁcant improvement (P < 0.01).
There were no complications related to the surgery, nor was any spinal instability detected. Three patients (8.6%) experienced persistent radiculopathy and subsequently underwent open microdiscectomy at the same level. We concluded that transforaminal percutaneous endoscopic discectomy is safe and eﬃcacious in the treatment of foraminal or extraforaminal disc herniations. However, proper patient selection is paramount to ensure a satisfactory outcome after decompression of foraminal and extraforaminal disc herniations.
A retrospective analysis of 41 patients operated for excision of soft lumbar extraforaminal disc herniation (EFDH) by percutaneous endoscopic extraforaminal approach under local anesthesia by a new technique.
To describe a new and safer percutaneous endoscopic technique for the removal of soft EFDH and report the results on the basis of a new objective criterion modified from Oswestry Disability Index (ODI).
Summary of Background Data
EFDHs usually occur in older patients and present with atypical symptoms. Their diagnosis and treatment are still controversial, with various authors describing open midline or paraspinal approaches using the microscope with varying amounts of success. Percutaneous endoscopic techniques have traditionally been considered unsuitable for these herniations.