Results of transforaminal endoscopic discectomy for lumbosacral disc herniation added by nucleoplasty

Introduction. Herniated disks are very common. Percutaneous endoscopic lumbar spine surgery for the lumbar disc herniation facilitates minimalized access ports to the operating site with decreased risk of infection, reduced blood loss and less tissue dissection and muscle trauma.

The goal was to compare the results of standard transforaminal endoscopic discectomy for lumbosacral herniation and outcomes of the procedure added by nucleoplasty.

Material and methods. Percutaneous transforaminal endoscopic discectomy was performed for 92 patients and added by nucleoplasty in 43 patients of group I. Preoperative and postoperative evaluation was produced with the Visual Analog Pain Scale (VAS), the Oswestry Low Back Pain Disability Questionnaire (ODI) and the MacNab clinical outcome score. Complication and recurrence rate was reviewed. Microsoft Office Excell and Statistica 8.0 were used to complete data analysis reports.

Results. VAS scores decreased from 7.9 to 3.1 showing 2.5-fold decrease (p less 0.05), and ODI scores decreased from 71.09 to 18.58) (p less 0.001) demonstrating fourfold decrease at one-year follow-up. There were no significant differences in VAS and ODI scores between the groups preoperatively and postoperatively (p > 0.05). The majority of patients of group I (41.86 %) rated their health status as excellent on the MacNab scale, and the majority of patients of group II (53.06 %) rated their health status as good. Postoperative complication rate was 11.63% in group I and 12.24% in group II (p > 0.05). There was no recurrence in group I with the recurrence rate of 6.1% (p less 0.001) in group II.

Conclusion. Endoscopic discectomy for lumbosacral herniation supplemented with nucleoplasty can reduce the recurrence rate.

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