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Transforaminal percutaneous endoscopic lumbar discectomy for upper lumbar disc herniation: clinical outcome, prognostic factors, and technical consideration

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An Erratum to this article was published on 21 July 2009

Abstract

Background

Compared with lower lumbar disc herniations, upper lumbar disc herniations at L1–L2 and L2–L3 have specific characteristics that result in different surgical outcomes after conventional open discectomy. There are no published studies on the feasibility of percutaneous endoscopic lumbar discectomy for upper lumbar disc herniation. The purpose of this study was to assess the clinical outcome, prognostic factors and the technical pitfalls of PELD for upper lumbar disc herniation.

Method

Forty-five patients with a soft disc herniation at L1–L2 or L2–L3 underwent percutaneous endoscopic discectomy. Posterolateral transforaminal endoscopic laser-assisted disc removal was performed under local anesthesia. Clinical outcomes was assessed using the Prolo scale. The prognostic factors associated with outcome were then analyzed.

Findings

The mean follow-up was 38.8 months (range, 25–52 months). The outcome of the 45 patients was excellent in 21 (46.7%), good in 14 patients (31.1%), fair in six patients (13.3%), and poor in four patients (8.9%). Four patients with a poor outcome underwent further open surgery. Mean scores on a visual analog scale decreased from 8.38 to 2.36 (P < 0.0001). Age less than 45 years and a lateral disc herniation were independently associated with an excellent outcome (P < 0.05).

Conclusions

Patient selection and an anatomically modified surgical technique promote a more successful outcome after percutaneous endoscopic discectomy for upper lumbar disc herniation.

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Authors and Affiliations

  1. Department of Neurosurgery, Wooridul Spine Hospital, Daegu, 700-732, South Korea

    Yong Ahn

  2. Department of Neurosurgery, Wooridul Spine Hospital, Seoul, South Korea

    Sang-Ho Lee & June Ho Lee

  3. Department of Orthopedic Surgery, Wooridul Spine Hospital, Seoul, South Korea

    Jin Uk Kim

  4. Department of Radiology, Wooridul Spine Hospital, Seoul, South Korea

    Wei Chiang Liu

  5. Wooridul Spine Hospital, 50-3 Dongin-dong, Jung-gu, Daegu, 700-732, South Korea

    Yong Ahn

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  1. Yong Ahn
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  2. Sang-Ho Lee
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  3. June Ho Lee
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  4. Jin Uk Kim
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  5. Wei Chiang Liu
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Correspondence to Yong Ahn.

Additional information

Disclosure: This study was supported by a grant from the Wooridul Spine Foundation.

An erratum to this article can be found at http://dx.doi.org/10.1007/s00701-009-0457-4

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Ahn, Y., Lee, SH., Lee, J.H. et al. Transforaminal percutaneous endoscopic lumbar discectomy for upper lumbar disc herniation: clinical outcome, prognostic factors, and technical consideration. Acta Neurochir (Wien) 151, 199–206 (2009). https://doi.org/10.1007/s00701-009-0204-x

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