Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study
Objective To compare the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) for posterior ring apophyseal fractures (PRAF). Methods This study was a retrospective cohort control study. A total of 96 patients with lumbar PRAF who underwent...
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| Format: | Article |
| Language: | English |
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Wiley
2020-08-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.12698 |
| _version_ | 1819143908006821888 |
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| author | Yao‐bin Wang Shu‐lian Chen Chen Cao Kai Zhang Li‐min Liu Yan‐zheng Gao |
| author_facet | Yao‐bin Wang Shu‐lian Chen Chen Cao Kai Zhang Li‐min Liu Yan‐zheng Gao |
| author_sort | Yao‐bin Wang |
| collection | DOAJ |
| description | Objective To compare the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) for posterior ring apophyseal fractures (PRAF). Methods This study was a retrospective cohort control study. A total of 96 patients with lumbar PRAF who underwent surgical treatment at the Henan Provincial People's Hospital of Henan University from September 2013 to December 2017 were retrospectively examined, of which 51 were treated by PTED and 45 by FD. The average age of those in the PTED group was 28.24 years, including 38 males and 13 females. The average age of those in the FD group was 28.07 years, with 33 males and 12 females. Operation time, total blood loss, hospitalization days, preoperative and postoperative visual analog scale (VAS), and Oswestry disability index (ODI) scores were evaluated. Modified MacNab criteria were used to evaluate the clinical effect at the last follow‐up. Results Both operations were successful and no serious complications occurred. All patients were followed up for 12–30 (average 16.7 ± 3.2) months, and no patients were lost to follow‐up. No statistically significant difference was found in the mean age and gender between the PTED group and the FD group (P < 0.05). Operation time, total blood loss, and length of hospital stay were significantly lower in the PTED group (87.65 ± 13.15 min, 12.78 ± 4.95 mL, and 6.80 ± 1.67 days, respectively) than in the FD group (114.11 ± 14.39 min, 30.89 ± 7.09 mL, and 11.71 ± 1.98 days, respectively) (P < 0.05). The VAS and ODI scores of the two groups at postoperative day 1 (PTED: 3.82 ± 0.97, 37.73% ± 3.72%; FD: 3.62 ± 1.09, 36.62% ± 3.05%), and at 3 months (PTED: 2.90 ± 1.08, 26.02% ± 2.90%; FD: 3.07 ± 0.99, 27.16% ± 4.02%), 6 months (PTED: 2.31 ± 0.88, 22.53% ± 2.67%; FD: 2.36 ± 0.77, 21.18% ± 3.35%), and the last follow‐up (PTED: 1.90 ± 0.83, 19.88% ± 3.01%; FD: 1.89 ± 0.86, 18.22% ± 3.03%) were significantly different from the preoperative scores (PTED: 6.53 ± 1.00, 55.24% ± 4.54%; FD: 6.78 ± 1.31, 53.56% ± 5.73%) (P < 0.05). The VAS and ODI scores at 3 months postoperatively, 6 months postoperatively, and the last follow up were not significantly different between the two groups (P > 0.05). In the PTED group, 2 patients developed a transient nerve stimulation symptom within 1 day after surgery and 1 patient had recurrence at 3 months after surgery. In the FD group, 2 patients had severe dural ruptures due to adhesion during surgery, 1 patient developed infection complications, and 2 patients relapsed at 2 and 3 months after surgery. At the last follow‐up, the modified MacNab criteria for clinical effect were 93.3% and 94.1% in the FD and PTED groups, respectively. Conclusion While PTED has the same efficacy as FD for treating PRAF, it is associated with shorter operation time, less trauma, and quicker recovery. |
| first_indexed | 2024-12-22T12:33:42Z |
| format | Article |
| id | doaj.art-da4fa95799f846a99656a5e73103b9c0 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-12-22T12:33:42Z |
| publishDate | 2020-08-01 |
| publisher | Wiley |
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| series | Orthopaedic Surgery |
| spelling | doaj.art-da4fa95799f846a99656a5e73103b9c02022-12-21T18:25:36ZengWileyOrthopaedic Surgery1757-78531757-78612020-08-011241092109910.1111/os.12698Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort StudyYao‐bin Wang0Shu‐lian Chen1Chen Cao2Kai Zhang3Li‐min Liu4Yan‐zheng Gao5Department of Orthopaedics Henan Provincial People's Hospital of Henan University Zhengzhou ChinaDepartment of Orthopaedics Henan Provincial People's Hospital of Henan University Zhengzhou ChinaDepartment of Orthopaedics Henan Provincial People's Hospital of Henan University Zhengzhou ChinaDepartment of Orthopaedics Henan Provincial People's Hospital of Henan University Zhengzhou ChinaDepartment of Orthopaedics Henan Provincial People's Hospital of Henan University Zhengzhou ChinaDepartment of Orthopaedics Henan Provincial People's Hospital of Henan University Zhengzhou ChinaObjective To compare the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) for posterior ring apophyseal fractures (PRAF). Methods This study was a retrospective cohort control study. A total of 96 patients with lumbar PRAF who underwent surgical treatment at the Henan Provincial People's Hospital of Henan University from September 2013 to December 2017 were retrospectively examined, of which 51 were treated by PTED and 45 by FD. The average age of those in the PTED group was 28.24 years, including 38 males and 13 females. The average age of those in the FD group was 28.07 years, with 33 males and 12 females. Operation time, total blood loss, hospitalization days, preoperative and postoperative visual analog scale (VAS), and Oswestry disability index (ODI) scores were evaluated. Modified MacNab criteria were used to evaluate the clinical effect at the last follow‐up. Results Both operations were successful and no serious complications occurred. All patients were followed up for 12–30 (average 16.7 ± 3.2) months, and no patients were lost to follow‐up. No statistically significant difference was found in the mean age and gender between the PTED group and the FD group (P < 0.05). Operation time, total blood loss, and length of hospital stay were significantly lower in the PTED group (87.65 ± 13.15 min, 12.78 ± 4.95 mL, and 6.80 ± 1.67 days, respectively) than in the FD group (114.11 ± 14.39 min, 30.89 ± 7.09 mL, and 11.71 ± 1.98 days, respectively) (P < 0.05). The VAS and ODI scores of the two groups at postoperative day 1 (PTED: 3.82 ± 0.97, 37.73% ± 3.72%; FD: 3.62 ± 1.09, 36.62% ± 3.05%), and at 3 months (PTED: 2.90 ± 1.08, 26.02% ± 2.90%; FD: 3.07 ± 0.99, 27.16% ± 4.02%), 6 months (PTED: 2.31 ± 0.88, 22.53% ± 2.67%; FD: 2.36 ± 0.77, 21.18% ± 3.35%), and the last follow‐up (PTED: 1.90 ± 0.83, 19.88% ± 3.01%; FD: 1.89 ± 0.86, 18.22% ± 3.03%) were significantly different from the preoperative scores (PTED: 6.53 ± 1.00, 55.24% ± 4.54%; FD: 6.78 ± 1.31, 53.56% ± 5.73%) (P < 0.05). The VAS and ODI scores at 3 months postoperatively, 6 months postoperatively, and the last follow up were not significantly different between the two groups (P > 0.05). In the PTED group, 2 patients developed a transient nerve stimulation symptom within 1 day after surgery and 1 patient had recurrence at 3 months after surgery. In the FD group, 2 patients had severe dural ruptures due to adhesion during surgery, 1 patient developed infection complications, and 2 patients relapsed at 2 and 3 months after surgery. At the last follow‐up, the modified MacNab criteria for clinical effect were 93.3% and 94.1% in the FD and PTED groups, respectively. Conclusion While PTED has the same efficacy as FD for treating PRAF, it is associated with shorter operation time, less trauma, and quicker recovery.https://doi.org/10.1111/os.12698DiscectomyFenestrationLumbarPercutaneous transforaminal endoscopicPosterior ring apophyseal fracture |
| spellingShingle | Yao‐bin Wang Shu‐lian Chen Chen Cao Kai Zhang Li‐min Liu Yan‐zheng Gao Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study Orthopaedic Surgery Discectomy Fenestration Lumbar Percutaneous transforaminal endoscopic Posterior ring apophyseal fracture |
| title | Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study |
| title_full | Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study |
| title_fullStr | Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study |
| title_full_unstemmed | Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study |
| title_short | Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study |
| title_sort | percutaneous transforaminal endoscopic discectomy and fenestration discectomy to treat posterior ring apophyseal fractures a retrospective cohort study |
| topic | Discectomy Fenestration Lumbar Percutaneous transforaminal endoscopic Posterior ring apophyseal fracture |
| url | https://doi.org/10.1111/os.12698 |
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