Goker Burcu, Aydin Salih
Istinye University, School of Medicine, Liv Hospital Ulus, Department of Neurosurgery, Istanbul, Turkey.
Turk Neurosurg. 2020;30(1):112-118. doi: 10.5137/1019-5149.JTN.27360-19.3.
To determine the feasibility and efficacy of full endoscopic interlaminar discectomy (FEID) for recurrent disc herniation.
This retrospective single-center study included 60 patients. Among them, 36 who previously had microdiscectomy underwent revisional FEID (MD group), and 24 who previously had FEID underwent revisional FEID (FEID group). In addition to general parameters, the following measurement tools were used: visual analog scale (VAS) and Oswestry disability index (ODI) questionnaire.
No statistically significant difference was observed in length of hospitalization, time to return to work, complications, and recurrences between the two groups. Both the FEID and MD groups had a significant decrease in postoperative VAS and ODI scores. The mean operation time was shorter in the FEID group than in the MD group, and the result was significantly different (p < 0.05). During the 36-month follow-up, no significant differences were observed in postoperative VAS and ODI scores between the two groups. Moreover, none of the patients developed complications correlated to surgery. However, three patients with a previous history of microdiscectomy or endoscopic discectomy had recurrence despite revisional endoscopic surgery.
Percutaneous revisional full endoscopic lumbar disc surgery is a safe and effective procedure that does not cause additional structural damage. Full endoscopic technique can be used safely for recurrent disc herniations regardless if a patient underwent microscopic or endoscopic surgery.
确定全内镜下椎间孔切开椎间盘切除术(FEID)治疗复发性椎间盘突出症的可行性和疗效。
这项回顾性单中心研究纳入了60例患者。其中,36例曾接受过显微椎间盘切除术的患者接受了FEID翻修手术(MD组),24例曾接受过FEID手术的患者接受了FEID翻修手术(FEID组)。除一般参数外,还使用了以下测量工具:视觉模拟量表(VAS)和Oswestry功能障碍指数(ODI)问卷。
两组在住院时间、恢复工作时间、并发症和复发率方面均未观察到统计学上的显著差异。FEID组和MD组术后VAS和ODI评分均显著降低。FEID组的平均手术时间比MD组短,结果有显著差异(p < 0.05)。在36个月的随访期间,两组术后VAS和ODI评分均未观察到显著差异。此外,没有患者出现与手术相关的并发症。然而,3例曾接受过显微椎间盘切除术或内镜下椎间盘切除术的患者尽管接受了内镜翻修手术仍复发。
经皮翻修全内镜下腰椎间盘手术是一种安全有效的手术方法,不会造成额外的结构损伤。无论患者之前接受的是显微手术还是内镜手术,全内镜技术均可安全用于复发性椎间盘突出症。