Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(04): 415-418
DOI: 10.1055/s-0039-3402473
Artigos Originais
Coluna

Functional Evolution after Percutaneous Endoscopic Lumbar Discectomy, an Earlier Evaluation of 32 Cases[∗]

Article in several languages: português | English
Bruno César Aprile 
1   Departamento de Coluna, Clínica SOU, São Paulo, SP, Brasil
,
Marcelo Campos Moraes Amato
2   Departamento de Coluna, Instituto Amato, São Paulo, SP, Brasil
,
Cézar Augusto de Oliveira
1   Departamento de Coluna, Clínica SOU, São Paulo, SP, Brasil
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective To determine time period for hospital discharge and pain and function improvement in patients submitted to percutaneous endoscopic lumbar discectomy (PELD).

Methods Retrospective evaluation of length of stay and visual analog scale (VAS), Oswestry disability index (ODI), and Roland-Morris questionnaire results in 32 patients undergoing PELD at the preoperative period and at 2 days and 1, 2, 4, 6 and 12 postoperative weeks.

Results All patients were discharged in less than 6 hours. There was a statistically significant improvement between the results obtained before the procedure and 2 days postsurgery: the mean VAS for axial pain went from 6.63 to 3.31, the VAS for irradiated pain went from 6.66 to 2.75, the Oswestry score went from 44.59 to 33.17%, and the Roland-Morris score went from 14.03 to 10.34. This difference progressively improved up to 12 weeks in all questionnaires. Regarding the Oswestry score, minimum disability values (19.39%) were observed at 6 weeks.

Conclusion All 32 patients were discharged within 6 hours. Pain and function improved significantly after 48 hours, with further significant and progressive improvement until the 3rd month.

Keywords

vertebral spine - intervertebral disc dislocation - outcome evaluation (healthcare) - endoscopy

∗ Work developed at Clínica SOU and at Instituto Amato, São Paulo, SP, Brazil.




Publication History

Received: 14 June 2019

Accepted: 15 August 2019

Article published online:
11 March 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

  • Referências

  • 1 Botelho RV, Canto FT, Carvalho MV. , et al. Diretrizes Clínicas na Saúde Suplementar - Hérnia de disco Lombar no Adulto: Tratamento Cirúrgico. São Paulo: Sociedade Brasileira de Ortopedia e Traumatologia e Sociedade Brasileira de Neurocirurgia; 2011
    Google Scholar
  • 2 Peng CWB, Yeo W, Tan SB. Percutaneous endoscopic lumbar discectomy: clinical and quality of life outcomes with a minimum 2 year follow-up. J Orthop Surg Res 2009; 4: 20
    CrossrefPubMedGoogle Scholar
  • 3 Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine 2008; 33 (09) 931-939
    CrossrefPubMedGoogle Scholar
  • 4 Choi KC, Kim JS, Park CK. Percutaneous Endoscopic Lumbar Discectomy as an Alternative to Open Lumbar Microdiscectomy for Large Lumbar Disc Herniation. Pain Physician 2016; 19 (02) E291-E300
    CrossrefPubMedGoogle Scholar
  • 5 Phan K, Xu J, Schultz K. , et al. Full-endoscopic versus micro-endoscopic and open discectomy: A systematic review and meta-analysis of outcomes and complications. Clin Neurol Neurosurg 2017; 154 (01) 1-12
    CrossrefPubMedGoogle Scholar
  • 6 Ruan W, Feng F, Liu Z, Xie J, Cai L, Ping A. Comparison of percutaneous endoscopic lumbar discectomy versus open lumbar microdiscectomy for lumbar disc herniation: A meta-analysis. Int J Surg 2016; 31: 86-92
    CrossrefPubMedGoogle Scholar
  • 7 Pan L, Zhang P, Yin Q. Comparison of tissue damages caused by endoscopic lumbar discectomy and traditional lumbar discectomy: a randomised controlled trial. Int J Surg 2014; 12 (05) 534-537
    CrossrefPubMedGoogle Scholar
  • 8 Feng F, Xu Q, Yan F. , et al. Comparison of 7 Surgical Interventions for Lumbar Disc Herniation: A Network Meta-analysis. Pain Physician 2017; 20 (06) E863-E871
    PubMedGoogle Scholar
  • 9 Ahn SS, Kim SH, Kim DW, Lee BH. Comparison of Outcomes of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Microdiscectomy for Young Adults: A Retrospective Matched Cohort Study. World Neurosurg 2016; 86: 250-258
    CrossrefPubMedGoogle Scholar
  • 10 Li X, Han Y, Di Z. , et al. Percutaneous endoscopic lumbar discectomy for lumbar disc herniation. J Clin Neurosci 2016; 33: 19-27
    CrossrefPubMedGoogle Scholar
  • 11 Birkenmaier C, Komp M, Leu HF, Wegener B, Ruetten S. The current state of endoscopic disc surgery: review of controlled studies comparing full-endoscopic procedures for disc herniations to standard procedures. Pain Physician 2013; 16 (04) 335-344
    CrossrefPubMedGoogle Scholar
  • 12 Casimiro M. Short-Term Outcome Comparison Between Full-Endoscopic Interlaminar Approach and Open Minimally Invasive Microsurgical Technique for Treatment of Lumbar Disc Herniation. World Neurosurg 2017; 108: 894-900.e1
    CrossrefPubMedGoogle Scholar
  • 13 Li M, Yang H, Yang Q. Full-Endoscopic Technique Discectomy Versus Microendoscopic Discectomy for the Surgical Treatment of Lumbar Disc Herniation. Pain Physician 2015; 18 (04) 359-363
    PubMedGoogle Scholar
  • 14 Kapetanakis S, Giovannopoulou E, Charitoudis G, Kazakos K. Health-related quality of life (HRQoL) following transforaminal percutaneous endoscopic discectomy (TPED) for lumbar disc herniation: A prospective cohort study - early results. J Back Musculoskeletal Rehabil 2017; 30 (06) 1311-1317
    CrossrefPubMedGoogle Scholar
  • 15 Chen HT, Tsai CH, Chao SC. , et al. Endoscopic discectomy of L5-S1 disc herniation via an interlaminar approach: Prospective controlled study under local and general anesthesia. Surg Neurol Int 2011; 2: 93
    CrossrefPubMedGoogle Scholar
  • 16 Porchet F, Bartanusz V, Kleinstueck FS. , et al. Microdiscectomy compared with standard discectomy: an old problem revisited with new outcome measures within the framework of a spine surgical registry. Eur Spine J 2009; 18 (Suppl. 03) 360-366
    CrossrefPubMedGoogle Scholar
  • 17 Li XC, Zhong CF, Deng GB, Liang RW, Huang CM. Full-Endoscopic Procedures Versus Traditional Discectomy Surgery for Discectomy: A Systematic Review and Meta-analysis of Current Global Clinical Trials. Pain Physician 2016; 19 (03) 103-118
    PubMedGoogle Scholar
  • 18 Markovic M, Zivkovic N, Ruetten S, Ozdemir S, Goethel D. Full-endoscopic interlaminar versus microsurgical operations in lumbar compressive lesions surgery: prospective randomized trial of overall 570 patients. J Pain Relief 2017; 6 (06) 1-7
    Google Scholar
  • 19 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. J Korean Neurosurg Soc 2009; 46 (06) 515-521
    CrossrefPubMedGoogle Scholar
  • 20 Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine 2008; 33 (09) 940-948
    CrossrefPubMedGoogle Scholar
  • 21 Lee SH, Chung SE, Ahn Y, Kim TH, Park JY, Shin SW. Comparative radiologic evaluation of percutaneous endoscopic lumbar discectomy and open microdiscectomy: a matched cohort analysis. Mt Sinai J Med 2006; 73 (05) 795-801
    Google Scholar
  • 22 Righesso O, Falavigna A, Avanzi O. Comparison of open discectomy with microendoscopic discectomy in lumbar disc herniations: results of a randomized controlled trial. Neurosurgery 2007; 61 (03) 545-549 , discussion 549
    CrossrefPubMedGoogle Scholar
  • 23 Matsumoto M, Watanabe K, Hosogane N. , et al. Recurrence of lumbar disc herniation after microendoscopic discectomy. J Neurol Surg A Cent Eur Neurosurg 2013; 74 (04) 222-227
    PubMedGoogle Scholar
  • 24 Tenenbaum S, Arzi H, Herman A. , et al. Percutaneous posterolateral transforaminal endoscopic discectomy: clinical outcome, complications, and learning curve evaluation. Surg Technol Int 2011; 21: 278-283
    PubMedGoogle Scholar