Faculty Collaboration Database

Transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral and foraminal lumbar disc herniations. J Neurosurg 2001 Apr;94(2 Suppl):216-20

Date

04/17/2001

Pubmed ID

11302623

DOI

10.3171/spi.2001.94.2.0216

Scopus ID

2-s2.0-0034873695 (requires institutional sign-in at Scopus site)   140 Citations

Abstract

OBJECT: Far-lateral (extraforaminal) and foraminal disc herniations comprise up to 11% of all herniated intervertebral discs. Operative management can be technically difficult, and the optimum surgical treatment remains controversial. Accessing these lateral disc herniations endoscopically via a percutaneous transforaminal approach offers several theoretical advantages over the more traditional procedures. The object of this study was to assess the safety and efficacy of treating patients with far-lateral and foraminal disc herniations via a percutaneous transforaminal endoscopic approach.

METHODS: A retrospective analysis was performed of 47 consecutive patients who underwent surgery via this approach. All procedures were performed after induction of a local anesthetic on an outpatient basis. Outcome was measured with Macnab criteria and by determining a patient's return-to-work status. The median follow-up period was 18 months (range 4-51 months). Excellent or good outcome was obtained in 40 (85%) of 47 patients. Of the 38 patients working before the onset of symptoms, 34 (90%) returned to work. Five patients (11%) experienced poor outcomes and subsequently underwent open procedures at the same level. Of the 10 recipients of Workers' Compensation, Macnab criteria indicated a significantly worse outcome (70% excellent or good), but an excellent return-to-work status was maintained (90%). There were no complications.

CONCLUSIONS: Transforaminal percutaneous endoscopic discectomy is safe and efficacious in the treatment of far-lateral and foraminal disc herniations.

Author List

Lew SM, Mehalic TF, Fagone KL

Author

Sean Lew MD Chief, Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Diskectomy
Endoscopy
Female
Humans
Intervertebral Disc Displacement
Leg
Lumbar Vertebrae
Male
Middle Aged
Pain
Postoperative Period
Reoperation
Retrospective Studies
Treatment Outcome