Comparison of the Interlaminar and Transforaminal Approaches for Full-endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation
This study aims to compare the outcomes of interlaminar and transforaminal approaches for full-endoscopic discectomy (FED) for treating L4/5 lumbar disc herniation (LDH). A retrospective study of patients with L4/5 LDH treated with interlaminar endoscopic lumbar discectomy (IELD, n = 19) or transfor...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Japan Neurosurgical Society
2023-07-01
|
| Series: | Neurologia Medico-Chirurgica |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/nmc/63/7/63_2022-0357/_pdf/-char/en |
| _version_ | 1797749476499128320 |
|---|---|
| author | Kento TAKEBAYASHI Yasushi OSHIMA Muneyoshi FUJITA Takahiro INUI Hiroki IWAI Hirohiko INANAMI Hisashi KOGA |
| author_facet | Kento TAKEBAYASHI Yasushi OSHIMA Muneyoshi FUJITA Takahiro INUI Hiroki IWAI Hirohiko INANAMI Hisashi KOGA |
| author_sort | Kento TAKEBAYASHI |
| collection | DOAJ |
| description | This study aims to compare the outcomes of interlaminar and transforaminal approaches for full-endoscopic discectomy (FED) for treating L4/5 lumbar disc herniation (LDH).
A retrospective study of patients with L4/5 LDH treated with interlaminar endoscopic lumbar discectomy (IELD, n = 19) or transforaminal endoscopic lumbar discectomy (TELD, n = 105) was conducted. Patient background, radiological findings, and operative data were collected. Oswestry Disability Index (ODI) and European Quality of Life-5 Dimension (EQ-5D) scores were recorded preoperatively and 1 and 2 years postoperatively.
Although ODI and EQ-5D scores 1 and 2 years postoperatively improved statistically in the IELD and TELD groups, there were no statistical differences between the groups. IELD was predominantly performed in patients who were taller and heavier. The mean operative times and the frequency of laminectomy for IELD and TELD were 67.2 and 44.6 min and 63.2 and 17.1%, respectively (P < 0.001). The radiological findings showed that the concave configuration of the L4 lamina, interlaminar space width, and foraminal width were statistically different between the groups. There were no complications in either of the groups. Reoperation was required for recurrence in two and five patients in the IELD and TELD groups (P = 0.29), respectively.
Operative outcomes were identical between the two groups. Although the operative time was longer in the IELD group, both approaches were safely and effectively performed. Depending on the patient's physique and preoperative radiological findings, the more suitable approach for L4/5 LDH should be chosen. |
| first_indexed | 2024-03-12T16:19:37Z |
| format | Article |
| id | doaj.art-8d4a2f5ac51c4dc984fb1fb370ad910e |
| institution | Directory Open Access Journal |
| issn | 1349-8029 |
| language | English |
| last_indexed | 2024-03-12T16:19:37Z |
| publishDate | 2023-07-01 |
| publisher | The Japan Neurosurgical Society |
| record_format | Article |
| series | Neurologia Medico-Chirurgica |
| spelling | doaj.art-8d4a2f5ac51c4dc984fb1fb370ad910e2023-08-08T23:34:16ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292023-07-0163731332010.2176/jns-nmc.2022-03572022-0357Comparison of the Interlaminar and Transforaminal Approaches for Full-endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc HerniationKento TAKEBAYASHI0Yasushi OSHIMA1Muneyoshi FUJITA2Takahiro INUI3Hiroki IWAI4Hirohiko INANAMI5Hisashi KOGA6Department of Neurosurgery, Iwai FESS ClinicDepartment of Orthopaedic Surgery, The University of TokyoDepartment of Neurosurgery, Iwai FESS ClinicDepartment of Orthopaedic Surgery, Teikyo University School of MedicineDepartment of Neurosurgery, Iwai FESS ClinicDepartment of Neurosurgery, Iwai FESS ClinicDepartment of Neurosurgery, Iwai FESS ClinicThis study aims to compare the outcomes of interlaminar and transforaminal approaches for full-endoscopic discectomy (FED) for treating L4/5 lumbar disc herniation (LDH). A retrospective study of patients with L4/5 LDH treated with interlaminar endoscopic lumbar discectomy (IELD, n = 19) or transforaminal endoscopic lumbar discectomy (TELD, n = 105) was conducted. Patient background, radiological findings, and operative data were collected. Oswestry Disability Index (ODI) and European Quality of Life-5 Dimension (EQ-5D) scores were recorded preoperatively and 1 and 2 years postoperatively. Although ODI and EQ-5D scores 1 and 2 years postoperatively improved statistically in the IELD and TELD groups, there were no statistical differences between the groups. IELD was predominantly performed in patients who were taller and heavier. The mean operative times and the frequency of laminectomy for IELD and TELD were 67.2 and 44.6 min and 63.2 and 17.1%, respectively (P < 0.001). The radiological findings showed that the concave configuration of the L4 lamina, interlaminar space width, and foraminal width were statistically different between the groups. There were no complications in either of the groups. Reoperation was required for recurrence in two and five patients in the IELD and TELD groups (P = 0.29), respectively. Operative outcomes were identical between the two groups. Although the operative time was longer in the IELD group, both approaches were safely and effectively performed. Depending on the patient's physique and preoperative radiological findings, the more suitable approach for L4/5 LDH should be chosen.https://www.jstage.jst.go.jp/article/nmc/63/7/63_2022-0357/_pdf/-char/enlumbar disc herniationfull-endoscopic discectomyminimally invasiveinterlaminar approachtransforaminal approach |
| spellingShingle | Kento TAKEBAYASHI Yasushi OSHIMA Muneyoshi FUJITA Takahiro INUI Hiroki IWAI Hirohiko INANAMI Hisashi KOGA Comparison of the Interlaminar and Transforaminal Approaches for Full-endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation Neurologia Medico-Chirurgica lumbar disc herniation full-endoscopic discectomy minimally invasive interlaminar approach transforaminal approach |
| title | Comparison of the Interlaminar and Transforaminal Approaches for Full-endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation |
| title_full | Comparison of the Interlaminar and Transforaminal Approaches for Full-endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation |
| title_fullStr | Comparison of the Interlaminar and Transforaminal Approaches for Full-endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation |
| title_full_unstemmed | Comparison of the Interlaminar and Transforaminal Approaches for Full-endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation |
| title_short | Comparison of the Interlaminar and Transforaminal Approaches for Full-endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation |
| title_sort | comparison of the interlaminar and transforaminal approaches for full endoscopic discectomy for the treatment of l4 5 lumbar disc herniation |
| topic | lumbar disc herniation full-endoscopic discectomy minimally invasive interlaminar approach transforaminal approach |
| url | https://www.jstage.jst.go.jp/article/nmc/63/7/63_2022-0357/_pdf/-char/en |
| work_keys_str_mv | AT kentotakebayashi comparisonoftheinterlaminarandtransforaminalapproachesforfullendoscopicdiscectomyforthetreatmentofl45lumbardischerniation AT yasushioshima comparisonoftheinterlaminarandtransforaminalapproachesforfullendoscopicdiscectomyforthetreatmentofl45lumbardischerniation AT muneyoshifujita comparisonoftheinterlaminarandtransforaminalapproachesforfullendoscopicdiscectomyforthetreatmentofl45lumbardischerniation AT takahiroinui comparisonoftheinterlaminarandtransforaminalapproachesforfullendoscopicdiscectomyforthetreatmentofl45lumbardischerniation AT hirokiiwai comparisonoftheinterlaminarandtransforaminalapproachesforfullendoscopicdiscectomyforthetreatmentofl45lumbardischerniation AT hirohikoinanami comparisonoftheinterlaminarandtransforaminalapproachesforfullendoscopicdiscectomyforthetreatmentofl45lumbardischerniation AT hisashikoga comparisonoftheinterlaminarandtransforaminalapproachesforfullendoscopicdiscectomyforthetreatmentofl45lumbardischerniation |