Abstract
Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common spine diseases which are mainly due to age related Spine degeneration. Diagnosis of both Lumbar Disc Herniation and Lumbar Spine Stenosis depends on clinical findings as well as radiological investigations. Treatment of choice of these conditions is on the basis of the patient conditions. Surgical treatment is the option only when the conservative treatment does not improve the patient’s clinical condition. Advancement and improvement of the technology have resulted in the traditional open surgical treatment into minimal invasive surgery. Intervention of the different surgical instruments with expert spinal surgeons had made percutaneous endoscopic lumbar Spine surgery as one of the preferred choices of surgery for treating Lumbar Disc Herniation and Lumbar Spine Stenosis. The concept of percutaneous endoscopic surgery for lumbar region is to provide surgical options without producing iatrogenic morbidity associated with the open surgical procedures. Conventionally, there are different approaches/techniques for Percutaneous Endoscopic Lumbar Spine Surgery, but in this review we are mainly focusing on the Transforaminal Technique. Regarding the Lumbar Disc Herniation treatment with transforaminal approach, a number of articles have been published due to which we mainly focused on those articles which were published after 2009 onwards. While fewer articles related to Lumbar Spine Stenosis treatment with Transforaminal approach were found, we tried to brief out all those articles. On the basis of comparative study of different surgeries done for Lumbar Disc Herniation and Lumbar Spine Stenosis, Percutaneous Transforaminal endoscopic Lumbar Surgery provides a substantial benefit. Transforaminal approach for treating Lumbar Disc Herniation and Lumbar Spine Stenosis is safe and effective. The Percutaneous Transforaminal Endoscopic Lumbar Surgery has advantage as it is performed under local anesthesia with shorter length of hospitalization and early return to normal life. The clinical outcome of the patient that underwent Percutaneous Transforaminal Endoscopic Lumbar Surgery for Lumbar Disc Herniation and Lumbar Spine Stenosis is quite good in regard of its fewer complication and more benefits.
Highlights
Regarding the Lumbar Disc Herniation treatment with transforaminal approach, a number of articles have been published due to which we mainly focused on those articles which were published after 2009 onwards
While fewer articles related to Lumbar Spine Stenosis treatment with Transforaminal approach were found, we tried to brief out all those articles
When a patient presents with the typical symptoms of lumbar spinal stenosis, a conclusive diagnosis is made using imaging studies from an Magnetic Resonance imaging Yeung Endoscopic Spine System (YESS) (MRI) scan or a CT scan with myelogram [25] [26]
Summary
Lumbar disc herniation [1] [2] [3] (Figure 1(a)) is a medical condition affecting the spine in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out beyond the damage outer rings (Figure 1(b)). Lumbar disc herniation may cause severe pain even in the absence of nerve root compression. Lumbar spine stenosis [17] [18] [19] is a medical condition described by Verbiest [20] in 1950 in which the spinal canal narrows and compresses the nerves at the level of the lumbar vertebrae (Figure 2). When a patient presents with the typical symptoms of lumbar spinal stenosis (leg pain, with or without back pain, which is aggravated by walking), a conclusive diagnosis is made using imaging studies from an MRI scan or a CT scan with myelogram (using an x-ray dye in the spinal sack fluid) [25] [26]. CT and MRI scanning are done for the definitive diagnosis of LSS
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