ABSTRACT
OBJECTIVE@#To investigate the early clinical effects of transforaminal endoscopic spine system (TESSYS) for the treatment of bilateral lumbar disc herniation in single segment.@*METHODS@#The clinical data of 38 patients with single-segment bilateral lumbar disc herniation treated by TESSYS technique from February 2016 to February 2018 were retrospectively analyzed. There were 26 males and 12 females, aged from 30 to 55 years old with an average of(35.2±6.4) years, 6 cases of L₃,₄, 22 cases of L₄,₅, and 10 cases of L₅S₁1. Using the intervertebral foramen endoscope produced by Joimax GmbH, Germany, under local anesthesia, bilateral puncture to the outside of the intervertebral foramen of the diseased segment, four-stage dilatation catheter to complete the progressive enlargement of the intervertebral foramen, and the ring saw progressively enlarge the intervertebral foramen. The bilateral foramen was placed and the herniated nucleus was removed until the nerve root was completely released. Postoperatively, the patients were reviewed on regular outpatient visits and telephone follow-ups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were compared before operation and after operation at 1, 3, 6, 12 months respectively. At the final follow-up, according to modified MacNab criteria to evaluate the clinical effect.@*RESULTS@#Thirty-six patients underwent successful surgery and were followed up for more than 12 months. The ODI score and VAS score of the lower extremities pain at 1, 3, 6, 12 months after operation were obviously improved (0.05). At the final follow-up, according to MacNab criteria, 14 cases got excellent results, 16 good, 4 fair, 2 poor.@*CONCLUSIONS@#Using TESSYS technique to remove the bilateral herniated nucleus from single segment can fully decompress for the nerve root, and can be effectively applied to patients with single-segment bilateral lumbar disc herniation.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Diskectomy, Percutaneous , Endoscopy , Intervertebral Disc Degeneration , Intervertebral Disc Displacement , Lumbar Vertebrae , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To observe the clinical efficacy of the TESSYS (transforaminal endoscopic spine system) technique of percutaneous transforaminal endoscopic discectomy combined with oral use of Chinese medicine for the treatment of lumbar disc herniation.Methods Thirty-nine patients with lumbar disc herniation were treated by the TESSYS technique of percutaneous transforaminal endoscopic discectomy,and then received oral use of modified herbal medicine Xubi Recipe,a formula mainly having the actions of tonifying kidney and strengthening governor vessel for 4 weeks after the operation.The visual analogue scale (VAS) and Oswestry disability index (ODI) and modified MacNab criteria were employed to assessed the surgical outcomes before the operation,and 3 and 6 months after the operation.Results (1) All of the 39 cases completed the operation successfully,and were followed up for 6-12 months after the operation.(2) Three and 6 months after the operation,the VAS scores and ODI scores were obviously lower than those before the operation,and the differences were significant (P ＜ 0.05).(3) Six months after the operation,the excellent rate of clinical efficacy assessed by modified MacNab criteria was 89.74％.(4) Only 4 cases had severer transient pain and numbness in the affected limbs,and there was no occurrence of complications of permanent neural root trauma,dural tear,vascular injury,intestinal damage,spondylodiscitis or retroperitoneal hematoma.Conclusion The TESSYS technique of percutaneous transforaminal endoscopic discectomy combined with oral use of Chinese medicine is effective for the treatment of the lumbar disc herniation with the advantages of satisfactory short-term effect,less bleeding,less trauma,faster recovery and less complications.
ABSTRACT
Objective To observe the clinical effect of transforaminal endoscopic surgical system (TESSYS) technique for atypical lumbar disc herniation. Methods Eighteen patients with atypical lumbar disc herniation underwent TESSYS technique under local anesthesia. Numerical rating scale (NRS) was used to evaluate the sciatica and/or back pain. The outcomes were evaluated by Oswestry disability index (ODI) and the Macnab score. Results The postoperative NRS scales were significantly lower than preoperative one (P<0.01). The postoperative ODI was lower than preoperative one (P < 0.05). Good rate of modified Macnab criteria was 88.89%. One patient occurred right hip pain and disappeared after partial closure. one patient turned to open surgery at 1 week. Conclusion The TESSYS technique was an effective method for atypical lumbar disc herniation. It has satisfactory clinical effect which is worthy of spreading for clinical application.