Turkish Neurosurgery 2021 , Vol 31 , Num 6
Comparative Analysis of the Therapeutic Efficiency and Radiographic Measurement Between the Transforaminal Approach and Interlaminar Approach in Percutaneous Endoscopic Discectomy
Guodong YIN1,Chong WANG1,Shi-qin LIU1
1923nd Hospital of People?s Liberation Army, Department of Orthopedic Surgery, Nanning, Guangxi, P.R. China DOI : 10.5137/1019-5149.JTN.30241-20.4 AIM: To investigate and compare the therapeutic efficiency and radiographic measurement between the transforaminal approach and interlaminar approach in percutaneous endoscopic discectomy.

MATERIAL and METHODS: From January 2017 to January 2018, 86 patients suffering from single lumbar disc herniation were included in this retrospective analysis and divided into the percutaneous endoscopic transforaminal discectomy (PETD) group and percutaneous endoscopic interlaminar discectomy (PEID) group according to different surgical approaches. Data on age, gender, course of the disease, smoking status, and body mass index (BMI) were also obtained. Moreover, lumbar spine X-ray (anterior? posterior, lateral, and excessive flexion and extension), CT scan, and MRI were performed preoperatively for all patients. Another MRI of the lumbar spine was performed within the week after the operation. Clinical efficacy was calculated to assess the clinical effect of the therapy using the visual analogue scale (VAS) and Oswestry Disability Index (ODI) at 1 day before surgery, 3 months after surgery, 1 year after surgery, and the last follow-up visit.

RESULTS: All patients were followed up for above two year. 44 and 42 cases were enrolled, respectively, in the PETD and PEID groups. 62 males and 24 females were included in this study. The mean ages of the PETD and PEID groups were 34.58 ± 6.70 and 33.72 ± 7.12 years, respectively (p=0.763). The symptoms showed evident improvement after surgery, but there were no significant differences regarding VAS scores, ODI scores, spinal canal occupation rate and lumbar lordosis except disc height and pfirrmann grade between the two groups (p>0.05). The revision surgery rates of the PETD and PEID groups at the last follow-up time were 2.3% and 4.8%, respectively (p=0.612). One patient in the PETD group underwent PEID revision surgery because of residual disk herniation. Re-operation were performed on 2 patients in the PEID group due to recurrencee.

CONCLUSION: Approaches of the PEID and PETD are pivotal to address lumbar disc herniation (LDH) disease. Selection of surgery approach depends on anatomical structure, physiological characteristic and operative skill of the surgeon. Keywords : Lumbar disc herniation, Percutaneous endoscopic transforaminal discectomy, Percutaneous endoscopic interlaminar discectomy, Treatment

Corresponding author : Guodong YIN, ygd0810@126.com