Short-term effect of percutaneous foraminal lens assisted treatment of lumbar disc herniation with posterior vertebral margin disarticulation

HUANG Dianfeng; YU Liping; LIN Longquan; CAO Jie; ZHAO Feng

PDF(1645 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2023, Vol. 34 ›› Issue (5) : 417-420.

Short-term effect of percutaneous foraminal lens assisted treatment of lumbar disc herniation with posterior vertebral margin disarticulation

HUANG Dianfeng, YU Liping, LIN Longquan, CAO Jie, ZHAO Feng

Author information +

History +

Abstract

Objective To investigate the feasibility and clinical effect of percutaneous foraminoscope assisted lower foraminal approach of lumbar disc herniation with posterior vertebral margin disarticulation.Methods A total of 63 patients with lumbar disc herniation with posterior lumbar spine margin dissociation treated by percutaneous transforaminal approach from January 2018 to December 2020, including 21 patients at L_3-4 segment and 42 patients at L_4-5 segment, were retrospectively reviewed. Postoperative follow-up was evaluated according to MacNab scoring standard. The scores of patients' preoperative and final Oswestry disability index (ODI) and visual analog scale (VAS) of lumbar pain were compared.Results Sixty-three patients were followed for 6-14 months with a mean follow-up time of (11.8±1.4) months. The pain VAS score at the last follow-up was 0-2, with a mean of (0.9±0.3) points; the ODI index was 14% - 28% with a mean (19.7±3.8)% of the patients, and all the scores were significantly improved compared with those before operation, with statistical significance (P<0.05). The follow-up effect was evaluated by MacNab scoring standard: excellent in 56 cases, good in 6 cases, poor in 1 case, and the excellent and good rate was 98.4%.Conclusions Percutaneous foraminal approach assisted by endoscope is safe to treat lumbar disc herniation with vertebral posterior margin disconnection, and patients can recover quickly after surgery, which is worthy of further research and promotion.

Key words

lumbar disc herniation / vertebral body posterior border disconnection / foraminoscopic technique / foraminal access / removal of nucleus pulposus and isolated bone blocks

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

HUANG Dianfeng, YU Liping, LIN Longquan, CAO Jie, ZHAO Feng. Short-term effect of percutaneous foraminal lens assisted treatment of lumbar disc herniation with posterior vertebral margin disarticulation[J]. Medical Journal of the Chinese People Armed Police Forces. 2023, 34(5): 417-420

References

[1] 房星宇,李佳林,刘明霞,等. 腰椎间盘突出症在青年官兵中发病的相关因素研究[J]. 解放军预防医学杂志,2020,38(10):87-89.
[2] 宋基伟,李宏国,胡学昱,等. 下腰痛青年官兵椎间高度指数与腰椎间盘突出的关系研究[J]. 西北国防医学杂志,2020,41(5):287-292.
[3] Akhaddar A, Belabyad S.Spontaneous regression of posterior ring apophysis separation in lumbar spine[J].World Neurosurg,2018,119:304-305.
[4] 黄民锋,吴晓飞,刘万祥,等. 腰椎间盘突出并椎体后缘离断症精准治疗的研究进展[J]. 广西医学,2020,42(24):3232-3235.
[5] 杨虎,李鹏飞,贾楠,等.四种手术入路行椎间孔镜髓核摘除术治疗巨大型腰椎间盘突出的比较研究[J].中国修复重建外科杂志,2020,34(3):300-307.
[6] Bae J S, Rhee W T, Kim W J,et al. Clinical and radiologic analysis of posterior apophyseal ring separation associated with lumbar disc herniation[J]. J Korean Neurosurg Soc,2013, 53(3): 145-149.
[7] 陈思曈,石长斌.椎间孔镜在脊柱微创手术中的应用进展[J].中国临床神经外科杂志, 2021, 26(5):388-390
[8] 薛静波,晏怡果,王文军,等. 经皮全脊柱内镜技术治疗青少年腰椎椎体后缘离断症[J]. 中国矫形外科杂志, 2017, 25(19):1741-1745.
[9] Konovalov N A,Asyuin D S,Korolishin V A,et al. Percutaneous endoscopic discectomy in the treatment of patients with degenerative discectomy of the lumbosacral spine[J]. Zh Vopr Neirokhir lm N N Burbenko,2017,81(5):56-62.
[10] 黄威,蒋欣浩,刘平涛,等. 钙化型腰椎间盘突出症与腰椎间盘突出并椎体后缘离断症的诊断及手术治疗疗效分析[J]. 骨科,2021,12(1):14-18.
[11] Song H, Hu W,Liu Z,et al. Percutaneous endoscopic interlamininar discectomy of L₅-S₁ disc hernination: a comparison between intermittent endoscopy technique and full endoscopy technique [J].J Orthop Surg Res, 2017, 12(1):162.
[12] Manchikanti L, Hirsch J A. In response to risks and pitfalls of epidural injections during management of lumbar disc herniation: few comments[J]. Korean J Pain, 2015, 28(3):219-220.
[13] 徐昆,郝佳颖,杜元良,等.小尖刀联合神经妥乐平对腰椎间盘突出症术后残余神经痛炎性因子水平及腰部功能影响[J].临床军医杂志,2017, 19(3):223-224.
[14] 王作伟, 陈赞, 吴浩,等. 椎间孔镜技术安全性的解剖学研究[J]. 中国临床神经外科杂志, 2020, 25(7):451-453.
[15] 彭智愚,孔清泉. 腰椎间盘突出症或腰椎管狭窄症合并椎体后缘离断的诊断和内镜治疗进展[J]. 中国骨与关节杂志,2019,8(2):132-136.
[16] 施政,石东浩,仓海斌,等. 腰椎间盘突出症两种手术疗效比较及经皮椎间孔镜治疗的应用价值[J]. 武警医学,2020,31(9):753-756,761.
[17] 黄长安,喻景弈. 经皮内镜下治疗腰椎椎体后缘离断症的临床疗效分析[J]. 颈腰痛杂志,2020,41(6):722-724.