オカザキ　ケン   KEN OKAZAKI   岡崎　賢    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Posterolateral Transforaminal Full-Endoscopic Lumbar Discectomy for Foraminal or Extraforaminal Lumbar Disc Herniations.
掲載誌名	正式名：World neurosurgery 略　 称：World Neurosurg ISSNコード：18788769/18788750
掲載区分	国外
巻・号・頁	pp.1
著者・共著者	Yoshikane Koichi, Kikuchi Katsuhiko, Okazaki Ken
担当区分	最終著者,責任著者
発行年月	2020/12
概要	BACKGROUND:Surgical procedures via the posterior median or paramedian approach for lateral lumbar disc herniation require significant bone resection to reach the herniation. In contrast, posterolateral transforaminal full-endoscopic lumbar discectomy (FELD) allows direct access to the lateral disc herniation. This study aimed to determine the efficacy and safety of this procedure.METHODS:A total of 118 patients who underwent posterolateral transforaminal FELD were retrospectively examined. Data on surgical time, perioperative complications, and reoperation rate were reviewed from the medical records. Clinical evaluations were completed in 78 patients using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and numeric rating scale (NRS) for low back pain, lower limb pain, and lower limb numbness obtained at baseline and during a follow-up of more than 12 months.RESULTS:The mean operative time was 33.9 min. Postoperative transient dysesthesia occurred in 11 of 118 patients (9.3%). No other complications were observed. Reoperation was performed in nine patients (5.9%). All domains of JOABPEQ and NRS significantly improved during the follow-up period. The effectiveness rates of the JOABPEQ for measuring low back pain, lumbar function, walking ability, social life function, and mental health were 70.4%, 46.5%, 62.0%, 59.2%, and 32.4%, respectively. Using the Macnab criteria, excellent or good results were achieved in 52 patients (73%).CONCLUSIONS:Successful clinical results were obtained with a few complications and improvements in the domains of JOABPEQ and NRS. Posterolateral transforaminal FELD for lateral lumbar disc herniations is an effective and safe surgical option with minimal invasiveness and sufficient decompression.
DOI	10.1016/j.wneu.2020.11.141
PMID	33276171