Skip to main content

Advertisement

Log in

Transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral lumbar disc herniations in children

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The use of transforaminal percutaneous endoscopic discectomy for the treatment of far-lateral lumbar disc herniations has been applied mostly in adults. However, transforaminal percutaneous endoscopic discectomy in children has probably been rarely documented. The aim of this study was to assess the efficacy of transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral lumbar disc herniations in children.

Methods

Overall, 12 cases of far-lateral lumbar disc herniations were treated with the procedure of transforaminal percutaneous endoscopic discectomy between January 2010 and December 2014. There were seven male and five female children included, with an average age of 12.6 years (11–16 years). Pre-operative and post-operative (6 weeks, 6 months and 12 months) clinical outcome data (back and leg visual analog scale [VAS] and Macnab criteria) were collected along with clinical assessments of motor strength (graded 0–5).

Results

All patients were discharged to home on the same day of surgery. The average leg VAS score improved from 8.6 ± 1.6 to 2.1 ± 0.4 (p < 0.005). Six patients had excellent outcomes, five had good outcomes, one had fair outcomes, and none had poor outcomes, according to the Macnab criteria. Eleven of 12 patients had excellent or good outcomes, for an overall success rate of 91.6 %. No patients required re-operation. There were no incidental durotomies, infections, vascular or visceral injuries. There was one complication, a case of leg numbness caused by ganglion injury. The numbness improved after two weeks. After three months, it was obvious that the total area of numbness in the legs had become smaller. At last follow-up, the patient had no pain, and only a few areas with numbness remained and did not affect the patient’s activities of daily living.

Conclusions

Transforaminal percutaneous endoscopic discectomy achieved satisfactory results for children with far-lateral lumbar disc herniations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Madhok R, Kanter AS (2010) Extreme-lateral, minimally invasive, transpsoas approach for the treatment of far-lateral lumbar disc herniation. J Neurosurg Spine 12(4):347–350

    Article  PubMed  Google Scholar 

  2. Ryang YM, Oertel MF, Mayfrank L et al (2007) Transmuscular trocar technique—minimal access spine surgery for far lateral lumbar disc herniations. Minim Invasive Neurosurg 50(5):304–307

    Article  CAS  PubMed  Google Scholar 

  3. Abdullah AF, Ditto EW, Byrd EB et al (1974) Extreme-lateral lumbar disc herniations. Clinical syndrome and special problems of diagnosis. J Neurosurg 41(2):229–234

    Article  CAS  PubMed  Google Scholar 

  4. Tessitore E, de Tribolet N (2004) Far-lateral lumbar disc herniation: the microsurgical transmuscular approach. Neurosurgery 54(4):939–942

    Article  PubMed  Google Scholar 

  5. Epstein NE (2002) Foraminal and far lateral lumbar disc herniations: surgical alternatives and outcome measures. Spinal Cord 40(10):491–500

    Article  CAS  PubMed  Google Scholar 

  6. Slotkin Jonathan R, Mislow John MK, Day Arthur L et al (2007) Pediatric disk disease. Neurosurg Clin N Am 18(4):659–667

    Article  CAS  PubMed  Google Scholar 

  7. Mony B, Igor M, Revital B et al (2008) Unilateral partial hemilaminectomy for disc removal in a 1-year-old child. J Neurosurg Pediatr 2(2):133–135

    Article  Google Scholar 

  8. Durham SR, Sun PP, Sutton LN (2000) Surgically treated lumbar disc disease in the pediatric population: an outcome study. J Neurosurg 92(1 Suppl):1–6

    CAS  PubMed  Google Scholar 

  9. Raj K, Kumar V, Das NK et al (2007) Adolescent lumbar disc disease: findings and outcome. Childs Nerv Syst 23(11):1295–1299

    Article  Google Scholar 

  10. DeLuca PF, Mason DE, Weiand R et al (1994) Excision of herniated nucleus pulposus in children and adolescents. J Pediatr Orthop 14(3):318–322

    Article  CAS  PubMed  Google Scholar 

  11. Shillito J (1996) Pediatric lumbar disc surgery: 20 patients under 15 years of age. Surg Neurol 46(1):14–18

    Article  PubMed  Google Scholar 

  12. Thomas L, Raid A, Eldin EA (2012) Percutaneous endoscopic treatment of foraminal and extraforaminal disc herniation at the L5-S1 level. Acta Neurochir (Wien) 154(10):1789–1795

    Article  Google Scholar 

  13. Voyadzis J-M, Gala VC, Sandhu FA et al (2010) Minimally invasive approach for far lateral disc herniations: results from 20 patients. Minim Invasive Neurosurg 53(3):122–126

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lin Cai.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zheng, C., Wu, F. & Cai, L. Transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral lumbar disc herniations in children. International Orthopaedics (SICOT) 40, 1099–1102 (2016). https://doi.org/10.1007/s00264-016-3155-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-016-3155-x

Keywords

Navigation