Clinical Outcomes of Full‐Endoscopic Visualized Foraminoplasty and Discectomy for Lumbar Disc Herniation with Bilateral Radiculopathy
Objective The treatment of lumbar disc herniation (LDH) with bilateral radiculopathy using transforaminal endoscopic lumbar discectomy (TELD) remains challenging, especially at the L5/S1 level with narrow foramen or high iliac crest. Full‐endoscopic visualized foraminoplasty and discectomy (FEVFD) i...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-12-01
|
| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.14240 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846146867330547712 |
|---|---|
| author | Changgui Shi Lecheng Wu Guoke Tang Bin Sun Ning Xu Wenbo Lin Jia Liu Guohua Xu |
| author_facet | Changgui Shi Lecheng Wu Guoke Tang Bin Sun Ning Xu Wenbo Lin Jia Liu Guohua Xu |
| author_sort | Changgui Shi |
| collection | DOAJ |
| description | Objective The treatment of lumbar disc herniation (LDH) with bilateral radiculopathy using transforaminal endoscopic lumbar discectomy (TELD) remains challenging, especially at the L5/S1 level with narrow foramen or high iliac crest. Full‐endoscopic visualized foraminoplasty and discectomy (FEVFD) is a newly developed technique for LDH and lumbar stenosis. However, there is limited evidence on the efficacy of FEVFD technique in the treatment of LDH with bilateral radiculopathy. This study was to assess the clinical outcomes and safety of using FEVFD in the treatment of LDH with bilateral radiculopathy. Methods This retrospective study enrolled 63 patients with LDH presenting with bilateral radiculopathy between January 2018 and January 2022. Patients enrolled before January 2020 were treated using a conventional transforaminal endoscopic surgical system (TESSYS) technique (TESSYS, n = 33) and treated using a FEVFD technique after that (FEVFD, n = 30). The total operation time and the number of intraoperative fluoroscopies were recorded. The Oswestry Disability Index (ODI) and visual analog scale (VAS) were evaluated preoperatively and postoperatively (at 1‐month, 3‐month, 6‐month, and final follow‐ups). Global outcomes at final follow‐up were assessed using modified MacNab criteria. Results Compared with TESSYS, patients in FEVFD group had a shorter operation time (92.9 vs. 78.0 min). The intraoperative fluoroscopies in FEVFD group were significantly lower than those in TESSYS group (18.7 vs. 4.9). After the operation, the VAS and ODI scores at all follow‐ups in the two groups were significantly lower than those before operation. For the L5/S1 level, the values of VAS and ODI scores in FEVFD group were significantly lower than those of in TESSYS group at 3‐month, 6‐month, and final follow‐up. For the L4/5 level, however, no significant difference was found in VAS and ODI scores between these two groups at the follow‐ups. According to the modified MacNab criteria, the excellent‐to‐good rate in TESSYS and FEVFD groups was 84.8% and 90.0%, respectively. Conclusion For LDH with bilateral radiculopathy, using the FEVFD technique could not only reduce the operation time and radiation, but also improve the clinical outcomes at the L5/S1 level. |
| format | Article |
| id | doaj-art-0ab8fee03f6645c0ab187f064aef6ba5 |
| institution | Kabale University |
| issn | 1757-7853 1757-7861 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj-art-0ab8fee03f6645c0ab187f064aef6ba52024-12-02T00:45:54ZengWileyOrthopaedic Surgery1757-78531757-78612024-12-0116123014302510.1111/os.14240Clinical Outcomes of Full‐Endoscopic Visualized Foraminoplasty and Discectomy for Lumbar Disc Herniation with Bilateral RadiculopathyChanggui Shi0Lecheng Wu1Guoke Tang2Bin Sun3Ning Xu4Wenbo Lin5Jia Liu6Guohua Xu7Department of Orthopedic Surgery Changzheng Hospital, Naval Medical University Shanghai ChinaDepartment of Orthopedic Surgery Changzheng Hospital, Naval Medical University Shanghai ChinaDepartment of Orthopedic Surgery Changzheng Hospital, Naval Medical University Shanghai ChinaDepartment of Orthopedic Surgery Changzheng Hospital, Naval Medical University Shanghai ChinaDepartment of Orthopedic Surgery Changzheng Hospital, Naval Medical University Shanghai ChinaDepartment of Orthopedic Surgery Changzheng Hospital, Naval Medical University Shanghai ChinaDepartment of Orthopedic Surgery Changzheng Hospital, Naval Medical University Shanghai ChinaDepartment of Orthopedic Surgery Changzheng Hospital, Naval Medical University Shanghai ChinaObjective The treatment of lumbar disc herniation (LDH) with bilateral radiculopathy using transforaminal endoscopic lumbar discectomy (TELD) remains challenging, especially at the L5/S1 level with narrow foramen or high iliac crest. Full‐endoscopic visualized foraminoplasty and discectomy (FEVFD) is a newly developed technique for LDH and lumbar stenosis. However, there is limited evidence on the efficacy of FEVFD technique in the treatment of LDH with bilateral radiculopathy. This study was to assess the clinical outcomes and safety of using FEVFD in the treatment of LDH with bilateral radiculopathy. Methods This retrospective study enrolled 63 patients with LDH presenting with bilateral radiculopathy between January 2018 and January 2022. Patients enrolled before January 2020 were treated using a conventional transforaminal endoscopic surgical system (TESSYS) technique (TESSYS, n = 33) and treated using a FEVFD technique after that (FEVFD, n = 30). The total operation time and the number of intraoperative fluoroscopies were recorded. The Oswestry Disability Index (ODI) and visual analog scale (VAS) were evaluated preoperatively and postoperatively (at 1‐month, 3‐month, 6‐month, and final follow‐ups). Global outcomes at final follow‐up were assessed using modified MacNab criteria. Results Compared with TESSYS, patients in FEVFD group had a shorter operation time (92.9 vs. 78.0 min). The intraoperative fluoroscopies in FEVFD group were significantly lower than those in TESSYS group (18.7 vs. 4.9). After the operation, the VAS and ODI scores at all follow‐ups in the two groups were significantly lower than those before operation. For the L5/S1 level, the values of VAS and ODI scores in FEVFD group were significantly lower than those of in TESSYS group at 3‐month, 6‐month, and final follow‐up. For the L4/5 level, however, no significant difference was found in VAS and ODI scores between these two groups at the follow‐ups. According to the modified MacNab criteria, the excellent‐to‐good rate in TESSYS and FEVFD groups was 84.8% and 90.0%, respectively. Conclusion For LDH with bilateral radiculopathy, using the FEVFD technique could not only reduce the operation time and radiation, but also improve the clinical outcomes at the L5/S1 level.https://doi.org/10.1111/os.14240Bilateral RadiculopathyEndoscopeForaminoplastyLumbar Disc HerniationVisualization |
| spellingShingle | Changgui Shi Lecheng Wu Guoke Tang Bin Sun Ning Xu Wenbo Lin Jia Liu Guohua Xu Clinical Outcomes of Full‐Endoscopic Visualized Foraminoplasty and Discectomy for Lumbar Disc Herniation with Bilateral Radiculopathy Orthopaedic Surgery Bilateral Radiculopathy Endoscope Foraminoplasty Lumbar Disc Herniation Visualization |
| title | Clinical Outcomes of Full‐Endoscopic Visualized Foraminoplasty and Discectomy for Lumbar Disc Herniation with Bilateral Radiculopathy |
| title_full | Clinical Outcomes of Full‐Endoscopic Visualized Foraminoplasty and Discectomy for Lumbar Disc Herniation with Bilateral Radiculopathy |
| title_fullStr | Clinical Outcomes of Full‐Endoscopic Visualized Foraminoplasty and Discectomy for Lumbar Disc Herniation with Bilateral Radiculopathy |
| title_full_unstemmed | Clinical Outcomes of Full‐Endoscopic Visualized Foraminoplasty and Discectomy for Lumbar Disc Herniation with Bilateral Radiculopathy |
| title_short | Clinical Outcomes of Full‐Endoscopic Visualized Foraminoplasty and Discectomy for Lumbar Disc Herniation with Bilateral Radiculopathy |
| title_sort | clinical outcomes of full endoscopic visualized foraminoplasty and discectomy for lumbar disc herniation with bilateral radiculopathy |
| topic | Bilateral Radiculopathy Endoscope Foraminoplasty Lumbar Disc Herniation Visualization |
| url | https://doi.org/10.1111/os.14240 |
| work_keys_str_mv | AT changguishi clinicaloutcomesoffullendoscopicvisualizedforaminoplastyanddiscectomyforlumbardischerniationwithbilateralradiculopathy AT lechengwu clinicaloutcomesoffullendoscopicvisualizedforaminoplastyanddiscectomyforlumbardischerniationwithbilateralradiculopathy AT guoketang clinicaloutcomesoffullendoscopicvisualizedforaminoplastyanddiscectomyforlumbardischerniationwithbilateralradiculopathy AT binsun clinicaloutcomesoffullendoscopicvisualizedforaminoplastyanddiscectomyforlumbardischerniationwithbilateralradiculopathy AT ningxu clinicaloutcomesoffullendoscopicvisualizedforaminoplastyanddiscectomyforlumbardischerniationwithbilateralradiculopathy AT wenbolin clinicaloutcomesoffullendoscopicvisualizedforaminoplastyanddiscectomyforlumbardischerniationwithbilateralradiculopathy AT jialiu clinicaloutcomesoffullendoscopicvisualizedforaminoplastyanddiscectomyforlumbardischerniationwithbilateralradiculopathy AT guohuaxu clinicaloutcomesoffullendoscopicvisualizedforaminoplastyanddiscectomyforlumbardischerniationwithbilateralradiculopathy |