Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes
Abstract Objectives To evaluate the correlation between radiologic changes (Pfirrmann and Modic) and radicular pain intensity in patients who underwent transforaminal endoscopic surgery for lumbar disc herniation. Methods Series of cases with 39 patients, 50 intervertebral discs in preoperative ev...
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Thieme Revinter Publicações Ltda.
2022-03-01
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| Series: | Revista Brasileira de Ortopedia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000100055&tlng=en |
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| author | José Alberto Alves Oliveira Rossana Ribeiro de Melo Ramos Francisco Julio Muniz Neto Paulo Cesar de Almeida Max Rogerio Freitas Ramos Paulo Sergio Teixeira de Carvalho |
| author_facet | José Alberto Alves Oliveira Rossana Ribeiro de Melo Ramos Francisco Julio Muniz Neto Paulo Cesar de Almeida Max Rogerio Freitas Ramos Paulo Sergio Teixeira de Carvalho |
| author_sort | José Alberto Alves Oliveira |
| collection | DOAJ |
| description | Abstract Objectives To evaluate the correlation between radiologic changes (Pfirrmann and Modic) and radicular pain intensity in patients who underwent transforaminal endoscopic surgery for lumbar disc herniation. Methods Series of cases with 39 patients, 50 intervertebral discs in preoperative evaluation from January 29, 2018 to August 28, 2019 in an endoscopic spine surgery service. Demographic data, surgical indication, operative details and complications were obtained from medical records. The patients were divided into three groups based on the Modic classification (Modic absence, Modic 1 and Modic 2) and into two groups considering the Pfirrmann classification (Pfirrmann IV and Pfirrmann V). Data were processed in IBM SPSS Statistics for Windows, Version 22.0 (IBM Corp., Armonk, NY, USA), with a significance level of p< 0,05. Results There was no difference between genders; age: 50,36 ± 15,05 years old; disease level: L2-L3 1 (2%), L3-L4 2 (4%), L4-L5 9 (18%), L5-S1 8 (16%), L3-L4 + L4-L5 4 (8%), and L4-L5 + L5-S1 26 (52%); location: right foraminal 7 (14%), left foraminal 15 (30%), central 9 (18%) and diffuse 19 (38%); radicular pain: left 25 (50%), right 11 (22%), and bilateral 14 (28%); preoperative visual analogue scale (VAS): 9,5 ± 0,91, postoperative: 2,5 ± 1,79; surgery duration: 100 ± 31,36 minutes; and follow-up: 8,4 ± 6,7 months. Less postoperative sciatica was registered in the Modic 2 versus Modic 1 group (p< 0,05). There was no difference in the postoperative radicular pain between the Pfirrmann groups (IV versus V). Conclusion Although there is no clinical difference between the groups, in advanced stages of disc degeneration, endoscopic transforaminal discectomy proved to be effective in diminishing radicular pain in patients with lumbar disc herniation. |
| first_indexed | 2024-03-08T07:23:08Z |
| format | Article |
| id | doaj.art-46466c4dc21e46a0b6cb32deebbb8856 |
| institution | Directory Open Access Journal |
| issn | 1982-4378 |
| language | English |
| last_indexed | 2024-04-24T14:11:46Z |
| publishDate | 2022-03-01 |
| publisher | Thieme Revinter Publicações Ltda. |
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| series | Revista Brasileira de Ortopedia |
| spelling | doaj.art-46466c4dc21e46a0b6cb32deebbb88562024-04-03T09:02:14ZengThieme Revinter Publicações Ltda.Revista Brasileira de Ortopedia1982-43782022-03-01571556010.1055/s-0041-1732387Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative ChangesJosé Alberto Alves Oliveirahttps://orcid.org/0000-0002-6424-1490Rossana Ribeiro de Melo Ramoshttps://orcid.org/0000-0002-5023-8266Francisco Julio Muniz Netohttps://orcid.org/0000-0001-6008-315XPaulo Cesar de Almeidahttps://orcid.org/0000-0002-2867-802XMax Rogerio Freitas Ramoshttps://orcid.org/0000-0002-8737-5010Paulo Sergio Teixeira de Carvalhohttps://orcid.org/0000-0001-8074-1463Abstract Objectives To evaluate the correlation between radiologic changes (Pfirrmann and Modic) and radicular pain intensity in patients who underwent transforaminal endoscopic surgery for lumbar disc herniation. Methods Series of cases with 39 patients, 50 intervertebral discs in preoperative evaluation from January 29, 2018 to August 28, 2019 in an endoscopic spine surgery service. Demographic data, surgical indication, operative details and complications were obtained from medical records. The patients were divided into three groups based on the Modic classification (Modic absence, Modic 1 and Modic 2) and into two groups considering the Pfirrmann classification (Pfirrmann IV and Pfirrmann V). Data were processed in IBM SPSS Statistics for Windows, Version 22.0 (IBM Corp., Armonk, NY, USA), with a significance level of p< 0,05. Results There was no difference between genders; age: 50,36 ± 15,05 years old; disease level: L2-L3 1 (2%), L3-L4 2 (4%), L4-L5 9 (18%), L5-S1 8 (16%), L3-L4 + L4-L5 4 (8%), and L4-L5 + L5-S1 26 (52%); location: right foraminal 7 (14%), left foraminal 15 (30%), central 9 (18%) and diffuse 19 (38%); radicular pain: left 25 (50%), right 11 (22%), and bilateral 14 (28%); preoperative visual analogue scale (VAS): 9,5 ± 0,91, postoperative: 2,5 ± 1,79; surgery duration: 100 ± 31,36 minutes; and follow-up: 8,4 ± 6,7 months. Less postoperative sciatica was registered in the Modic 2 versus Modic 1 group (p< 0,05). There was no difference in the postoperative radicular pain between the Pfirrmann groups (IV versus V). Conclusion Although there is no clinical difference between the groups, in advanced stages of disc degeneration, endoscopic transforaminal discectomy proved to be effective in diminishing radicular pain in patients with lumbar disc herniation.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000100055&tlng=ensciaticaintervertebral disc displacementlumbosacral region |
| spellingShingle | José Alberto Alves Oliveira Rossana Ribeiro de Melo Ramos Francisco Julio Muniz Neto Paulo Cesar de Almeida Max Rogerio Freitas Ramos Paulo Sergio Teixeira de Carvalho Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes Revista Brasileira de Ortopedia sciatica intervertebral disc displacement lumbosacral region |
| title | Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes |
| title_full | Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes |
| title_fullStr | Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes |
| title_full_unstemmed | Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes |
| title_short | Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes |
| title_sort | improvement in radicular pain after endoscopic transforaminal lumbar discectomy at discs with advanced degenerative changes |
| topic | sciatica intervertebral disc displacement lumbosacral region |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162022000100055&tlng=en |
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