A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5
Abstract Background Percutaneous endoscopic lumbar discectomy (PELD) has become popular for the treatment of symptomatic lumbar disc herniation (LDH). The very highly up-migrated lumbar disc herniation (VHUM-LDH) is difficult to remove under PELD. The purpose of this research is to investigate the f...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-08-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-021-04548-3 |
| _version_ | 1818363344164225024 |
|---|---|
| author | Yong Yu Ye Jiang Fuling Xu Yuhang Mao Lutao Yuan Chen Li |
| author_facet | Yong Yu Ye Jiang Fuling Xu Yuhang Mao Lutao Yuan Chen Li |
| author_sort | Yong Yu |
| collection | DOAJ |
| description | Abstract Background Percutaneous endoscopic lumbar discectomy (PELD) has become popular for the treatment of symptomatic lumbar disc herniation (LDH). The very highly up-migrated lumbar disc herniation (VHUM-LDH) is difficult to remove under PELD. The purpose of this research is to investigate the feasibility, clinical efficacy and operative nuances of a novel VTT involving TELF for this type of herniation. Methods Eleven patients with very highly up-migrated LDH who underwent VTT involving TELF discectomy from May 2016 to May 2019 were included in this study. The operative time, length of hospital stay, and postoperative complications were recorded. Pre-and postoperative radiologic findings were investigated. All the patients were followed more than 1 year. The visual analogue score (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores and modified MacNab criteria were used to assess surgical efficacy. Results All the 11 patients underwent successful surgery. We compared the VAS, ODI, and JOA scores before and after surgery. The differences were statistically significant (P < 0.05). According to the modified MacNab criteria, 10 patients were assessed as “excellent”, 1 patient was assessed as “good” at the last follow up. Conclusion The novel VTT involving TELF discectomy is a supplement to the traditional PELD. This technique enables the endoscope with working cannula to get closer the sequestrated nucleus pulposus without irritating the exiting nerve root, and facilitates the nucleus pulposus be removed successfully under direct visualization. The VTT involving TELF discectomy can be a safe, effective and feasible surgical procedure for the treatment of LDH with very highly up-migrated. |
| first_indexed | 2024-12-13T21:46:59Z |
| format | Article |
| id | doaj.art-cb1f258385794a46a228a67bccd65c5b |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-13T21:46:59Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-cb1f258385794a46a228a67bccd65c5b2022-12-21T23:30:24ZengBMCBMC Musculoskeletal Disorders1471-24742021-08-0122111110.1186/s12891-021-04548-3A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5Yong Yu0Ye Jiang1Fuling Xu2Yuhang Mao3Lutao Yuan4Chen Li5Department of Neurosurgery, Zhongshan Hospital, Fudan UniversityDepartment of Neurosurgery, Minhang Hospital, Fudan UniversityDepartment of Neurosurgery, Minhang Hospital, Fudan UniversityDepartment of Neurosurgery, Minhang Hospital, Fudan UniversityDepartment of Neurosurgery, Minhang Hospital, Fudan UniversityDepartment of Neurosurgery, Zhongshan Hospital, Fudan UniversityAbstract Background Percutaneous endoscopic lumbar discectomy (PELD) has become popular for the treatment of symptomatic lumbar disc herniation (LDH). The very highly up-migrated lumbar disc herniation (VHUM-LDH) is difficult to remove under PELD. The purpose of this research is to investigate the feasibility, clinical efficacy and operative nuances of a novel VTT involving TELF for this type of herniation. Methods Eleven patients with very highly up-migrated LDH who underwent VTT involving TELF discectomy from May 2016 to May 2019 were included in this study. The operative time, length of hospital stay, and postoperative complications were recorded. Pre-and postoperative radiologic findings were investigated. All the patients were followed more than 1 year. The visual analogue score (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores and modified MacNab criteria were used to assess surgical efficacy. Results All the 11 patients underwent successful surgery. We compared the VAS, ODI, and JOA scores before and after surgery. The differences were statistically significant (P < 0.05). According to the modified MacNab criteria, 10 patients were assessed as “excellent”, 1 patient was assessed as “good” at the last follow up. Conclusion The novel VTT involving TELF discectomy is a supplement to the traditional PELD. This technique enables the endoscope with working cannula to get closer the sequestrated nucleus pulposus without irritating the exiting nerve root, and facilitates the nucleus pulposus be removed successfully under direct visualization. The VTT involving TELF discectomy can be a safe, effective and feasible surgical procedure for the treatment of LDH with very highly up-migrated.https://doi.org/10.1186/s12891-021-04548-3Transforaminal endoscopic lumbar foraminotomyVery highly up-migratedVertebral trench technique |
| spellingShingle | Yong Yu Ye Jiang Fuling Xu Yuhang Mao Lutao Yuan Chen Li A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5 BMC Musculoskeletal Disorders Transforaminal endoscopic lumbar foraminotomy Very highly up-migrated Vertebral trench technique |
| title | A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5 |
| title_full | A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5 |
| title_fullStr | A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5 |
| title_full_unstemmed | A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5 |
| title_short | A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5 |
| title_sort | novel vertebral trench technique vtt involving transforaminal endoscopic lumbar foraminotomy telf for very highly up migrated lumbar disc herniation above l5 |
| topic | Transforaminal endoscopic lumbar foraminotomy Very highly up-migrated Vertebral trench technique |
| url | https://doi.org/10.1186/s12891-021-04548-3 |
| work_keys_str_mv | AT yongyu anovelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT yejiang anovelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT fulingxu anovelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT yuhangmao anovelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT lutaoyuan anovelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT chenli anovelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT yongyu novelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT yejiang novelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT fulingxu novelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT yuhangmao novelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT lutaoyuan novelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 AT chenli novelvertebraltrenchtechniquevttinvolvingtransforaminalendoscopiclumbarforaminotomytelfforveryhighlyupmigratedlumbardischerniationabovel5 |