Clinical Outcomes of Full Endoscopic Lumber Spine Surgery in the Management of Recurrent Disc Herniation
DOI:
https://doi.org/10.36552/pjns.v28i3.975Abstract
Introduction: Full-endoscopic lumbar discectomy (FELD) has been suggested as a potentially advantageous substitute for the surgical therapy of re-herniated lumber discs. This prospective study aimed to determine the clinical outcomes of full endoscopic lumber spine surgery in re-current disc herniation.
Material and Methods: This prospective observational study was conducted over 2 years, from May 2020 to May 2022 with a year follow-up period. The study included patients who presented to the outpatient department with lumbar disc re-herniation that was confirmed to be symptomatic by conducting clinical evaluation, magnetic resonance imaging (MRI), and/or computed tomography (CT) scans. Depending on the location and size of the disc herniation, either an interlaminar or transforaminal route was used during full endoscopic lumbar spine surgery.
Results: 442 lumbar disc surgeries were carried out in total over the 2-year research period. Of these procedures, 87 cases were reherniation surgeries, which made up about 19.6% of all lumbar disc surgeries. The majority of patients (80% in transforaminal and 75% in interlaminar) had incisions less than 8mm in length. Less than 5% of cases in both method groups experienced complications during the procedures, most of which were mild dural tears and bleeding.
Conclusion: This study concluded that recurring lumbar disc herniations can be safely treated with full endoscopic lumber spine surgery with good intra and post-operative outcomes while minimizing further structural damage compared to open interventions.
References
Abdu RW, Abdu WA, Pearson AM, Zhao W, Lurie JD, Weinstein JN. Reoperation for recurrent intervertebral disc herniation in the spine patient outcomes research trial: analysis of rate, risk factors, and outcome. Spine. 2017;42(14):1106-14.
Doi: 10.1097/BRS.0000000000002088
Miwa S, Yokogawa A, Kobayashi T, Nishimura T, Igarashi K, Inatani H, Tsuchiya H. Risk factors of recurrent lumbar disk herniation: a single center study and review of the literature. Clinical Spine Surgery. 2015;28(5):E265-9.
Doi: 10.1097/BSD.0b013e31828215b3
Shin EH, Cho KJ, Kim YT, Park MH. Risk factors for recurrent lumbar disc herniation after discectomy. International orthopaedics. 2019;43:963-7.
Doi: 10.1007/s00264-018-4201-7
Ambrossi GL, McGirt MJ, Sciubba DM, Witham TF, Wolinsky JP, Gokaslan ZL, Long DM. Recurrent lumbar disc herniation after single-level lumbar discectomy: incidence and health care cost analysis. Neurosurgery. 2009;65(3):574-8.
Doi: 10.1227/01.NEU.0000350224.36213.F9
Kim CH, Chung CK, Park CS, Choi B, Kim MJ, Park BJ. Reoperation rate after surgery for lumbar herniated intervertebral disc disease: nationwide cohort study. Spine. 2013;38(7):581-90.
Doi: 10.1097/BRS.0b013e318274f9a7
Mashhadinezhad H, Sarabi E, Mashhadinezhad S, Ganjeifar B. Clinical outcomes after microdiscectomy for recurrent lumbar disk herniation: a single-center study. Archives of Bone and Joint Surgery. 2018;6(5):397.
Doi: 10.22038/ABJS.2017.24932.1666
Huang W, Han Z, Liu J, Yu L, Yu X. Risk factors for recurrent lumbar disc herniation: a systematic review and meta-analysis. Medicine. 2016;95(2):e2378.
Doi: 10.1097/MD.0000000000002378
Kienzler JC, Fandino J, Van de Kelft E, Eustacchio S, Bouma GJ, Barricaid® Annular Closure RCT Study Group. Risk factors for early reherniation after lumbar discectomy with or without annular closure: results of a multicenter randomized controlled study. Acta neurochirurgica. 2021;163:259-68.
Doi: 10.1007/s00701-020-04505-4
Xu X, Chen C, Tang Y, Wang F, Wang Y. Clinical efficacy and safety of percutaneous spinal endoscopy versus traditional open surgery for lumbar disc herniation: systematic review and meta-analysis. Journal of Healthcare Engineering. 2022;2022. 6033989.
Doi: https://doi.org/10.1155/2022/
Mizuno J, Hirano Y, Nishimura Y. Establishment of endoscopic spinal neurosurgery and its current status. No shinkei geka. Neurological surgery. 2016;44(3):203-9.
Doi: https://doi.org/10.11477/mf.1436203258
Kapetanakis S, Charitoudis G, Thomaidis T, Theodosiadis P, Papathanasiou J, Giatroudakis K. Health-related quality of life after transforaminal percutaneous endoscopic discectomy: An analysis according to the level of operation. Journal of Craniovertebral Junction and Spine. 2017;8(1):44-9. Doi: 10.4103/0974-8237.199872
Kapetanakis S, Gkantsinikoudis N, Chaniotakis C, Charitoudis G, Givissis P. Percutaneous transforaminal endoscopic discectomy for the treatment of lumbar disc herniation in obese patients: health-related quality of life assessment in a 2-year follow-up. World neurosurgery. 2018;113:e638-49.
Doi: https://doi.org/10.1016/j.wneu.2018.02.112
Kapetanakis S, Gkantsinikoudis N, Papathanasiou JV, Charitoudis G, Thomaidis T. Percutaneous endoscopic ventral facetectomy: an innovative substitute of open decompression surgery for lateral recess stenosis surgical treatment? Journal of Craniovertebral Junction and Spine. 2018;9(3):188-95. Doi: 10.4103/jcvjs.JCVJS_76_18
Chen HC, Lee CH, Wei L, Lui TN, Lin TJ. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar surgery for adjacent segment degeneration and recurrent disc herniation. Neurology research international. 2015;2015.
Doi: https://doi.org/10.1155/2015/791943
Lee DY, Ahn Y, Lee SH. Percutaneous endoscopic lumbar discectomy for adolescent lumbar disc herniation: surgical outcomes in 46 consecutive patients. Mount Sinai Journal of Medicine. 2006;73(6).
Hoogland T, van den Brekel-Dijkstra K, Schubert M, Miklitz B. Endoscopic transforaminal discectomy for recurrent lumbar disc herniation: a prospective, cohort evaluation of 262 consecutive cases. Spine. 2008;33(9):973-8.
Doi: 10.1097/BRS.0b013e31816c8ade
Göker B, Ayd?n S. Endoscopic surgery for recurrent disc herniation after microscopic or endoscopic lumbar discectomy. Turkish neurosurgery. 2020.
Doi: 10.5137/1019-5149.JTN.27360-19.3
Yue JJ, Long W. Full endoscopic spinal surgery techniques: advancements, indications, and outcomes. International journal of spine surgery. 2015;9. Doi: https://doi.org/10.14444/2017
Vishteh AG, Dickman CA. Anterior lumbar microdiscectomy and interbody fusion for the treatment of recurrent disc herniation. Neurosurgery. 2001;48(2):334-8.
Doi: 10.1097/00006123-200102000-00018
Choi KB, Lee DY, Lee SH. Contralateral reherniation after open lumbar microdiscectomy: a comparison with ipsilateral reherniation. Journal of Korean Neurosurgical Society. 2008;44(5):320.
Doi: 10.3340/jkns.2008.44.5.320
Hoogland T, van den Brekel-Dijkstra K, Schubert M, Miklitz B. Endoscopic transforaminal discectomy for recurrent lumbar disc herniation: a prospective, cohort evaluation of 262 consecutive cases. Spine. 2008;33(9):973-8.
Doi: 10.1097/BRS.0b013e31816c8ade
Ahn Y, Lee SH, Park WM, Lee HY, Shin SW, Kang HY. Percutaneous endoscopic lumbar discectomy for recurrent disc herniation: surgical technique, outcome, and prognostic factors of 43 consecutive cases. Spine. 2004;29(16):E326-32.
Doi: 10.1097/01.BRS.0000134591.32462.98
Lee DY, Shim CS, Ahn Y, Choi YG, Kim HJ, Lee SH. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for recurrent disc herniation. Journal of Korean Neurosurgical Society. 2009;46(6):515.
Doi: 10.3340/jkns.2009.46.6.515
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Muhammad Farooq, Naeem ul Haq, Hafiz shahid, Mumtaz Ali, Muhammad Nawaz, Abdal wasim khan, Abdul Haseeb SahibzadaThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).