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Outcomes of percutaneous endoscopic trans-articular discectomy for huge central or paracentral lumbar disc herniation

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Abstract

Purpose

This study reports a new technique known as percutaneous endoscopic trans-articular discectomy (PETAD) for huge central/paracentral lumbar disc herniation (LDH).

Methods

Sixteen patients with huge central/paracentral LDH who underwent PETAD in our department from July 2015 to July 2016 were retrospectively analyzed. Clinical outcomes were evaluated according to pre-operative and post-operative visual analog scale (VAS) and Oswestry disability index (ODI) scores and the MacNab criteria. Immediate post-operative MRI and CT were conducted to confirm complete removal of LDH along with follow-up flexion-extension X-ray to observe lumbar stability.

Results

The huge central/paracentral LDH was completely removed by PETAD in 16 patients, as confirmed by post-operative MRI and CT. Leg pain was eased after removal of the disc herniations. The satisfactory (excellent/good) results were 93.7%. The mean follow-up duration was 15.6 (range, 3–24) months. The mean pre-operative VAS and ODI scores were 5.72 ± 1.18 (range, 4–9) and 60.1 (range, 51–87), respectively, which decreased to 1.26 ± 0.81 (range, 0–3) and 18.1 (range, 10–31), respectively at the third month post-operatively and to 0.78 ± 0.62 (range, 0–1) and 7.2 (range, 0–15), respectively by the last follow-up visit. No recurrence and segmental instability was observed in any of the 16 patients during the follow-up period.

Conclusion

PETAD could be a good alternative for treatment of huge central/paracentral LDH.

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Authors and Affiliations

  1. Department of Orthopedics Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wainan Street, Wuhou District, Chengdu, 610041, Sichuan, China

    Yu Wang, Yuqing Yan, Jin Yang, Lifeng Zhang, Chuan Guo, Zhiyu Peng, Hao Wu, Dongfeng Zhang & Qingquan Kong

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  1. Yu Wang
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  2. Yuqing Yan
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  3. Jin Yang
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  4. Lifeng Zhang
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  5. Chuan Guo
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Correspondence to Qingquan Kong.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Additional information

Yu Wang and Yuqing Yan are co-first authors.

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Wang, Y., Yan, Y., Yang, J. et al. Outcomes of percutaneous endoscopic trans-articular discectomy for huge central or paracentral lumbar disc herniation. International Orthopaedics (SICOT) 43, 939–945 (2019). https://doi.org/10.1007/s00264-018-4210-6

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