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Abstract
Objectives
To assess the clinical outcomes and roentgenographic changes after an percutaneous endoscopic discetomy of an intervertebral disc herniation of the lumbar spine.
Summary of Literature Review
Percutaneous endoscopic discectomy can preserve normal posterior element in the treatment for herniated intervertebral disc of lumbar spine.
Materials and Methods
Fifty two patients (41 men, 11 women), who had been treated with percutaneous endoscopic discectomy due to a herniated intevertebral disc of the lubar spine and were followed at least 1 year, were enrolled in this study. The mean age was 26.5 years (21∼45) and the mean follow- up period was 42 months (12∼76). Fifteen, 28 and 9 herniated discs were extracted from L3- L4, L4- L5 and L5- S1, respectively.
Results
A fter the percutaneous endoscopic discectomy, excellent and good results were obtained in 71% (37 cases) of patients but 9% (5 cases) of patients reported poor results. A roentgenographic assessment at the final follow- up showed no instability and no degenerative spondylotic finding. However, the intervertebral disc space was decreased in only 1 case.
REFERENCES
1). Dandy WE. Loose cartilage from intervertebral disc sim -ulating tumor of the spinal cord. By Walter E. Dandy, 1929 Clin Orthop Relat Res. 1989; 238:4–8.
2). Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl Surg Soc. 1934; 211:210–2154.
3). Hijikata S, Yamagishi M and Nakayama T. Perc uta -neous discectomy: A new treatment method for lumbar disc herniation. J Toden Hosp. 1975; 5:5–13.
4). Kambin P, Sampson S. Posterolateral percutaneous suction excision of herniated lumbar intervertebral discs: report of interim results. Clin Orthop. 1986; 207:37–43.
5). Onik G, Maroon J and Shang Y. Far-lateral disc herniation; treatment by automated percutaneous discectomy. AJNR. 1990; 11(5):865–8.
6). Hijikata S. Percutaneous nucleotomy: A new concept and 12 years' experience. Clin Orthop. 1989; 38:9–23.
7). Kambin P, Zhou L. Arthroscopic discectomy of the lumbar spine. Clin orthop. 1997; 337:49–57.
8). Schreiber A, Suezawa Y, Leu H. Does percutaneous nucleotomy with discoscopy replace conventional discectomy? Eight years of experience and results in treatment of herniated lumbar disc. Clin Orthop. 1989; 238:35–42.
9). Kambin P. Arthroscopic lumbar interbody fusion in white A(ed). Spine Care. St. Louis, CV Mosby. 1995; 1055-1066.
10). Kambin P. Posterolateral percutaneous lumbar interbody fusion. In Kambin P(ed). Arthroscopic microdiscectomy: Minimal intervention in spinal surgery. Baltimore, Urban & Schwarzenberg. 1991; 117-121.
11). MacNab I. Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients. JBJS Am. 1971; 53(5):891–903.
12). Smith L. Enzyme dissolution of the nucleus pulposus in humans. JAMA. 1964; 187:137–140.
13). Smith L, Garvin PJ, Gesler RM, Gennings RB. Enzyme dissolution of the nucleus pulposus. Nature. 1963; 198:1311–1312.
14). Schaffer JL, Kambin P. Percutaneous posterolateral lumbar discectomy and decompression with a 6.9mm can -nula: Analysis of operative failures and complications. J Bone Joint Surg. 1991; 73(6):822–831.
15). Casey KF, Chang MK, O'Brein ED, Yuan HA, McCullen GM, Schaffer J and Kambin P. Arthroscopic microdiscectomy: comparison of preoperative and postoperative imaging studies. Arthroscopy. 1997; 13:438–445.
16). Kambin P. The role of minimal invasive surgery in spinal disorder. Stauffer RN, editor. Advances in operative orthopaedics. 1996. 3. St Louis: Mosby yearbook Inc;p. 147–171.
17). Kambin P, Schreiber A, Shepperd J, Leu H and Schaffer J. Minimal intervention surgical techniques. Orthop Trans. 1993; 17:1132.
18). Chung JY, Joo DC. A Prospective Randomized Study of Arthroscopic and Microscopic Discectomy in Protruded Lumbar Disc Herniation. J Korean Orthop Ass. 2000; 35(1):119–126.
19). Yeung AT. The evolution of percutaneous spinal endoscopyand discectomy: state of the art. Mt Sinai J Med. 2000 Sep; 67(4):327–32.
20). Kambin P, Casey K, O'Brien E and Zhou L. Transforaminal arthroscopic decompression of lateral recess stenosis. J Neurosurg. 1996; 84:462–467.
21). Leu HJ, Schreiber A. Percutaneous fusion of the lumbar spine: A promising technique. Spine: State of the Art Reviews. 1992; 6:593–604.
Table 1.
MacNab classification
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