دورية أكاديمية
Transforaminal Unilateral Biportal Endoscopic Spinal Surgery for Extraforaminal Lumbar Disc Herniation: A Retrospective Observational Study.
| العنوان: | Transforaminal Unilateral Biportal Endoscopic Spinal Surgery for Extraforaminal Lumbar Disc Herniation: A Retrospective Observational Study. |
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| المؤلفون: | Wu CY; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan; Department of Neurosurgery, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan; Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan., Huang HM; Department of Neurosurgery, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan., Lee HC; Neuroscience Center, Everan Hospital, Taichung, Taiwan., Tang CH; Graduate Institute of Biomedical Science, College of Medicine, China Medical University, Taichung, Taiwan; Department of Pharmacology, School of Medicine, China Medical University, Taichung, Taiwan; Chinese Medicine Research Center, China Medical University, Taichung, Taiwan; Department of Medical Laboratory Science and Biotechnology, College of Health Science, Asia University, Taichung, Taiwan; Department of Medical Research, China Medical University Hsinchu Hospital, Hsinchu, Taiwan., Chen YH; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan., Chiu CD; Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Biomedical Science, College of Medicine, China Medical University, Taichung, Taiwan; Spine Center, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan. Electronic address: cdchiu4046@gmail.com. |
| المصدر: | World neurosurgery [World Neurosurg] 2024 Mar; Vol. 183, pp. e658-e667. Date of Electronic Publication: 2024 Jan 03. |
| نوع المنشور: | Observational Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York : Elsevier |
| مواضيع طبية MeSH: | Intervertebral Disc Displacement*/diagnostic imaging , Intervertebral Disc Displacement*/surgery , Diskectomy, Percutaneous*/methods, Male ; Humans ; Aged ; Female ; Retrospective Studies ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery ; Endoscopy/methods ; Pain/surgery ; Treatment Outcome |
| مستخلص: | Objective: Biportal endoscopic spinal surgery (BESS) is recommended as a safer and less destructive option for lumbar disc herniations. However, limited data exist on clinical outcomes for extraforaminal lumbar disc herniation (ELDH) surgery. This retrospective study presents our preliminary experience with transforaminal unilateral BESS for ELDH. Methods: Patients with lumbar radiculopathy refractory to conservative treatment, diagnosed with ELDH by magnetic resonance imaging, and treated with transforaminal unilateral BESS in 2021-2023 in 2 institutions in Taiwan were eligible for inclusion. Those with lumbar spondylolisthesis grade 2 or more with segmental instability, history of drug abuse or psychiatric diseases, or with a follow-up duration <1 year were excluded. Primary outcomes included visual analog scale for pain, assessed at 1 week, 1 month, 6 months, and 1 year using generalized estimating equations analysis; success and satisfaction of BESS graded by the Macnab criteria; and perioperative complications. Secondary outcomes were operative time and hospital length of stay. Results: Seventeen patients were included in the analysis, with a mean age of 65.8 years; 11 (64.7%) were males and 15 (88.2%) had no prior lumbar spine surgery. mean operative time was 107.9 minutes, and length of stay was 3.5 days. Graded by Macnab criteria, 16 (94.1%) of patients had good to excellent outcomes. Only 1 patient experienced complications. No recurrence/reoperation was observed. Generalized estimating equations analysis showed that postoperative visual analog scale scores decreased significantly at 1 week (adjusted Beta [aBeta] = -5.47, standard error: 0.29, P < 0.001), 1 month (aBeta = -5.82), 6 months (aBeta = -5.88), and 1 year (aBeta = -6.29). Conclusions: Transforaminal unilateral BESS is an alternative and feasible method for treating ELDH, producing good surgical outcomes with few complications and sustaining pain improvement. Future studies with larger patient numbers and comparisons between BESS and other minimally invasive techniques for ELDH are warranted. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Extraforaminal lumbar disc herniation (ELDH); Transforaminal approach; Unilateral biportal endoscopic spinal surgery (BESS) |
| تواريخ الأحداث: | Date Created: 20240105 Date Completed: 20240313 Latest Revision: 20240628 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.wneu.2023.12.162 |
| PMID: | 38181875 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1878-8769 |
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| DOI: | 10.1016/j.wneu.2023.12.162 |