Abstract
BackgroundTransforaminal endoscopic discectomy was popular in the treatment of lumbar disc herniation. Previous study focuses on the leg pain of disc herniation, and little study concern the residual leg numbness after surgery. The purposes of this study were to evaluate the clinical outcomes of transforaminal endoscopic discectomy in the treatment of lumbar disc herniation with leg pain and numbness.MethodsPatients with one level lumbar disc herniation who had transforaminal endoscopic lumbar discectomy from June 2016 to July 2019 were categorized into two groups according to the leg numbness. 293 patients initially fulfilled the study criteria, and 27 patients were lost to follow-up. Of the remaining 266 patients available for analysis, 81 cases with leg numbness and pain (A group), and 185 cases with leg pain (B). Endoscopic transforaminal lumbar discectomy was performed, and the clinical outcomes of blood loss, operation times, hospital stay days, pain (Visual Analog Scale, VAS-pain), numbness (VAS-numbness), functional disability (Oswestry Disability Index, ODI), and the disk height and intervertebral foramen height were recorded.ResultsAll patients with pain and numbness pre-operation in group A, complain of leg numbness during or just after walking or standing not diminished after surgery in group A, and no one complain numbness after surgery in group B. The pain index and ODI score were better than preoperational in all patients (P < 0.01), and no significant difference between two groups (P > 0.05). The postoperative disk and foramen height were no significant difference compare to preoperative in all patients (P > 0.05), and no significant difference between two groups (P > 0.05). The leg numbness symptoms last longer in central disc herniation patients (10.4 ± 2.2 months) than in paracentral (6.3 ± 2.1 months) and foraminal disc herniation patients (5.6 ± 2.3 months) after surgery (P < 0.01).ConclusionsBased on the results of this study, transforaminal endoscopic lumbar discectomy was effective and safe procedures in the treatment of disc herniation with leg pain and numbness. The leg numbness symptoms last longer in central disc herniation patients than in paracentral and foraminal disc herniation patients after surgery.
Highlights
Transforaminal endoscopic discectomy was popular in the treatment of lumbar disc herniation
The current trend of evolution lumbar disc surgery has been toward transforaminal endoscopic discectomy, which is a minimally invasive treatments aimed at removing nuclear material and decompression the nerve through devices were inserted percutaneous into intervertebral discs [8, 9]
The previous studies shown that transforaminal endoscopic discectomy has the advantages of minimal invasive doesn’t damage the spinal structures, safe procedures with less trauma and faster recovery, etc
Summary
Transforaminal endoscopic discectomy was popular in the treatment of lumbar disc herniation. The purposes of this study were to evaluate the clinical outcomes of transforaminal endoscopic discectomy in the treatment of lumbar disc herniation with leg pain and numbness. The main advantages of it was its lower extremity pain symptoms was released at once after operation, which was the reason for transforaminal endoscopic lumbar discectomy has become popular [6, 7, 10, 11]. The most common lower extremity symptoms of lumbar disc herniation is pain, but often accompanied by numbness, tingling, and sometimes a burning sensation [12,13,14,15,16,17,18]. In lumbar disc herniation patients, pain and numbness of the lower extremities are the most typical symptoms, which disturbed walking ability and limit their activity of daily living. The purpose of this study was to evaluate the clinical outcomes and efficacy of endoscopic transforaminal lumbar discectomy in the treatment of lumbar disc herniation with numbness
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