Comparison of transpedicular endoscopic sequestrectomy and discectomy in the treatment of lumbar intervertebral disc herniation with a high degree of migration

Abstract

Surgical treatment of intervertebral disc herniation with a high degree of migration (beyond the vertebral pedicle) is a difficult problem without an unambiguous solution. In this manuscript, we compare the effectiveness of transpedicular endoscopy and standard discectomy in the treatment of patients with this disease. To compare transpedicular endoscopic sequestrectomy and discectomy in the treatment of lumbar intervertebral disc herniation with a high degree of migration. There were 28 patients divided into 2 groups: group 1 - 13 patients after transpedicular endoscopic sequestrectomy, group 2 - 15 patients after discectomy. Transpedicular endoscopic sequestrectomy ensured significantly better intraoperative parameters (incision length, blood loss, surgery time) (p<0.01). In both groups, postoperative VAS score of leg pain was significantly reduced within a day after surgery from 7.4±1.3 to 0.7±0.7 and from 7.1±1 to 0.8±0.5, respectively. In the 1st group, VAS score of back pain regressed from 5.2±0.7 to 1.1±0.89 by the end of the 1st postoperative day. This value was 0.6±0.5 a year later. In the 2nd group, VAS score of back pain regressed from 4.9±1 to 2.5±0.9 by the end of the 1st postoperative day. This value was 2.8±2.3 a year later. According to McNab clinical outcome scale, excellent and good results after transpedicular endoscopic sequestrectomy were obtained in all 13 (100%) patients, after discectomy - in 80% of cases. Transpedicular endoscopic sequestrectomy is optimal for intervertebral disc herniation with a high degree of migration due to fast postoperative recovery and no complications.