Transforaminal Endoscopic Lumbar Discectomy: Clinical Outcomes and Complications

Asano, Leonardo Yukio Jorge; Bergamaschi, João Paulo Machado; Dowling, Álvaro; Rodrigues, Luciano Miller Reis

doi:10.1055/s-0039-1700822

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Revista Brasileira de Ortopedia

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Sumário

Original Articles • Rev. bras. ortop. 55 (01) • Jan-Feb 2020 • https://doi.org/10.1055/s-0039-1700822 copy

Transforaminal Endoscopic Lumbar Discectomy: Clinical Outcomes and Complications^* * Work developed At Faculdade de Medicina do ABC, Santo André, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To evaluate the clinical and functional results of transforaminal endoscopic lumbar discectomy.

Materials and Methods

From August 2015 to January 2017, 101 patients with lumbar disc hernia refractory to clinical treatment underwent endoscopic discectomy. Through clinical evaluation by the Visual Analogue Scale and functional evaluation by the Oswestry Disability Index questionnaire, the patients were analyzed in the preoperative period, the immediate postoperative period, at 1 month, 3 months, 6 months and 1 year after surgery.

Results

The mean age of the participants was 48.1 years. The most affected disc levels were L4-L5 and L5-S1. A total of 29 patients were treated at 2 disc levels. After 1 month of postoperative follow-up, the mean scores on the questionnaires (VAS and ODI) decreased significantly (p < 0.001).

Conclusion

Transforaminal endoscopic Lumbar discectomy has been shown to be a safe, effective and minimally-invasive alternative for the treatment of lumbar disc herniation. The procedure has advantages, such as short hospital stay, surgery performed under local anesthesia and sedation, early return to daily activities, and low rate of complications.

Keywords
intervertebral disc displacement; percutaneous discectomy; endoscopy; minimally-invasive surgical procedures

Variables	Values
Number of patients	101
Age (mean)	48.1
Male/Female	55/46
Body mass index (kg/m²) (mean)	28.2
Surgical disc level
L3-L4	2
L4-L5	19
L5-S1	11

Period	Evaluation
	VAS	p ^* ***** p < 0.05 = statistically significant difference (in comparison with the preoperative period).	ODI	p ^* ***** p < 0.05 = statistically significant difference (in comparison with the preoperative period).
Preoperative	16.37		15.51
1 week	6.15	< 0.001	7.62	< 0.001
1 month	5.42	< 0.001	5.77	< 0.001
3 months	4.00	< 0.001	3.82	< 0.001
6 months	3.81	< 0.001	3.74	< 0.001
12 months	3.76	< 0.001	3.46	< 0.001

Variable	Category	n	Mean value	p ^* ***** p < 0.05 = statistically significant difference.
Visual Analogue Scale	First 30 patients	30	6.00	0.444
	Last 30 patients	30	2.90
	Total	60
Oswestry Disability Index	First 30 patients	30	5.4	0.830
	Last 30 patients	30	2.83
	Total	60

Variable	Category	n	Mean value	p ^* ***** p < 0.05 = statistically significant difference.
Visual Analogue Scale	Not including L5-S1	40	3.93	0.997
	Including L5-S1	61	3.66
	Total	101	3.76
Oswestry Disability Index	Not including L5-S1	40	3.63	0.950
	Including L5-S1	61	3.34
	Total	101	3.46

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Leonardo Yukio Jorge Asano, Faculdade de Medicina do ABC, Avenida Príncipe de Gales 821, Vila Príncipe de Gales, Santo André, SP, 09060-650, Brasil (e-mail: Yukioja@hotmail.com).

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Transforaminal Endoscopic Lumbar Discectomy: Clinical Outcomes and Complications* * Work developed At Faculdade de Medicina do ABC, Santo André, SP, Brazil.

Abstract

Objective

Materials and Methods

Results

Conclusion

Transforaminal Endoscopic Lumbar Discectomy: Clinical Outcomes and Complications^* * Work developed At Faculdade de Medicina do ABC, Santo André, SP, Brazil.