KEN OKAZAKI
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Peer reviewed
Title Posterolateral Transforaminal Full-Endoscopic Lumbar Discectomy for Foraminal or Extraforaminal Lumbar Disc Herniations.
Journal Formal name:World neurosurgery
Abbreviation:World Neurosurg
ISSN code:18788769/18788750
Domestic / ForeginForegin
Volume, Issue, Page pp.1
Author and coauthor Yoshikane Koichi, Kikuchi Katsuhiko, Okazaki Ken
Authorship Last author,Corresponding author
Publication date 2020/12
Summary 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