Percutaneous Transforaminal Endoscopic Spine System with Target Technique for Treatment of Lumbar Spinal Disc Herniation in Scoliosis Patients

Presented at SMISS Annual Forum 2018
By Qingbing Meng
With

Disclosures: Qingbing Meng None

Introduction:

Although traditional open decompression, lumbar discectomy and instrumentation fusion are the gold standard surgical technique for the patients with the scoliosis combined with lumbar disc herniation (LDH), the surgery-induced tissue injury, the high economic burden, the high complication rate, the long hospital stay have been a big challenge in the past few years. Percutaneous endoscopic lumbar discectomy (PELD) and canal decompression have been used as a minimal invasive spinal technique not only for the LDH but also the spine stenosis, which shown successful results. The authors report the clinical results of the PELD technique in patients with scoliosis combined with the radiculopathy.

Aims/Objectives:

To evaluate clinical results of percutaneous transforaminal endoscopic spine system with target technique for treatment of lumbar spinal disc herniation in scoliosis patients.

Methods:

A total of 18 patients with degenerative scoliosis who got the radiculopathy were treated with PELD and foraminoplasty from January 2014 to June 2016.According the Schwab classification, there were 1 patient in Type 1, 1 in type 2, 3 in Type 3, 5 in type 4,8 in Type 5. Preoperative and postoperative clinical results were analyzed by visual analogue scale (VAS) scores and Macnab evaluation standardization.

Results:

During the operation, Lumbar disc herniation and spinal canal stenosis were detected at the symptomatic side of the operative level in all the patients, PELD and foraminoplasty was performed for all the patients. The visual analogue scale (VAS) score was significantly decreased from preoperative 8.1 ±1.5 to postoperative 2.0 ±0.8 at 1 day, 1.0 ±0.4 at 3 months after the surgery (P <0.05= Curative effect was excellent for 15 patients and fair for 3 patients according to Macnab evaluation standardization.

Conclusions:

PELD and foraminoplasty could be considered as a useful technique to treat the patients with scoliosis who got the radiculopathy instead of long instrumented fusion, which can preserve the normal structures, shorten the hospital stay, reduce the complication. Reasonable selection of operation indication and skilled operation skill is the key to a successful operation