Technique skill and clinical choices of the YESS and TESSYS in percutaneous transforaminal endoscopic discectomy for lumbar disc herniations.

Abstract

Objective To describe the techniques skill, indictions and clinical effects of the Yeung endoscopic spine system (YESS) and transforaminal endoscopic spine system (TESSYS) percutaneous transforaminal endoscopic techniques for lumbar disc herniations. Methods From September 2005 to May 2008, 201 patients with lumbar disc hemiations were treated with posterolateral endoscopic discectomy techniques. There were two techniques had been used in this group: 150 cases with YESS and 51 with TESSYS. There were 122 males and 79 females, with an average age of 33.5 years. Results The follow-up period was 12.5 months (range 3 to 36 months). 119 patients (follow-up rate was 79.3%) had been followed-up in YESS operative group, while 43 patients (follow-up rate was 84.3%) in TESSYS operative group. Pain was measured by means of the Visual Analogue Score (VAS), the patient satisfaction was evaluated by the Nakai outcome criteria. Mean VAS of YESS group was improved from 8.4±2.1 before the surgery to 2.4±0.8 one year after the surgery, while TESSYS group from 8.6±2.3 betore the surgery to 2.6±1.3 one year after the surgery. There scores all increased significantly compared with their preoperative ones. Overall, excellent or good outcomes were obtained in 87.5% of the YESS group and in 88.4% of the TESSYS group. No persistent nerve root injuries and dural tear were happened. Eight patients were unsatisfactory in YESS group and 3 in TESSYS group. Four patients (3.4%) were experienced persistent radiculopathy in YESS group, but only one (2.3%) happened radiculopathy in TESSYS group. Four recurrent cases (recurrent rate 3.4%) in YESS group and two recurrent patients (recurrent rate 4.7%) in TESSYS group had been underwent microendoscopic revision surgery. Conclusion Transforaminal percutaneous endoscopic discectomy is safe and effieacious in the treatment of lumbar disc herniations. However, proper selection for YESS and TESSYS techniques is important to ensure the successful and satisfactory outcome for the lumbar disc herniations. Key words: Intervertebral disk displacement; Endoseopes; Lumbar vertebrae