Introduction
Surgical technique
Materials and methods
Patients
ID PAT | Age | Sex | Weight (kg) | Height (cm) | BMI | Level | Side | Intervention duration (min) | Duration symptoms(months) | Recurrence | Recurrence time (months) |
---|---|---|---|---|---|---|---|---|---|---|---|
AA | 71 | M | 82 | 175 | 26.78 | L5-S1 | Right | 120 | 1 | NO | |
BD | 47 | M | 93 | 189 | 26.04 | L3-L4 | Left | 93 | 2 | NO | |
BR | 65 | M | 63 | 163 | 23.71 | L2-L3 | Right | 85 | 2 | NO | |
BAM | 71 | F | 72 | 168 | 25.51 | L4-L5 | Left | 18 | 2 | NO | |
BL | 31 | M | 97 | 190 | 26.87 | L5-S1 | Left | 70 | 3 | NO | |
BM | 66 | M | 90 | 165 | 33.06 | L4-L5 | Right | 100 | 3 | NO | |
BG | 74 | M | 95 | 170 | 32.87 | L4-L5 | Left | 35 | 0.5 | NO | |
CS | 59 | F | 43 | 155 | 17.90 | L3-L4 | Left | 60 | 1 | NO | |
CG | 54 | M | 70 | 170 | 24.22 | L4-L5 | Right | 85 | 12 | NO | |
CC | 71 | M | 83 | 167 | 29.76 | L4-L5 | Right | 65 | 2 | NO | |
CS | 60 | M | 66 | 166 | 23.95 | L4-L5 | Left | 80 | 3 | NO | |
CR | 60 | M | 91 | 183 | 27.17 | L4-L5 | Left | 60 | 2 | NO | |
FS | 79 | F | 67 | 160 | 26.17 | L3-L4 | Left | 150 | 2 | YES | 0 |
FE | 59 | M | 88 | 180 | 27.16 | L3-L4 | Right | 84 | 1 | NO | |
GR | 66 | M | 90 | 178 | 28.41 | L3-L4 | Right | 55 | 1 | NO | |
GE | 52 | M | 85 | 170 | 29.41 | L3-L4 e L4-L5 | Right | 150 | 1 | NO | |
GD | 65 | M | 88 | 170 | 30.45 | L3-L4 | Both | 75 (1)-80 (2) | 2 | NO | |
GI | 63 | M | 80 | 174 | 26.42 | L5-S1 | Right | 85 | 3.5 | NO | |
GI1 | 47 | M | 63 | 168 | 22.32 | L4-L5 | Left | 25 | 0.5 | NO | |
LF | 46 | M | 92 | 173 | 30.74 | L3-L4 | Left | 105 | 1 | NO | |
LL | 86 | F | 46 | 155 | 19.15 | L3-L4 | Right | 80 | 3 | NO | |
LG | 75 | F | 63 | 162 | 24.01 | L4-L5 | Left | 65 | 1 | NO | |
MM | 70 | M | 77 | 182 | 23.25 | L4-L5 | Right | 57 | 3 | NO | |
MM1 | 61 | M | 70 | 174 | 23.12 | L4-L5 | Left | 50 | 3 | NO | |
MN | 69 | F | 73 | 155 | 30.39 | L3-L4 | Left | 80 | 0.5 | NO | |
MMG | 62 | F | 100 | 175 | 32.65 | L3-L4 | Left | 105 | 7 | NO | |
MD | 70 | F | 78 | 154 | 32.89 | L4-L5 | Left | 160 | 2 | NO | |
MD | 55 | M | 98 | 187 | 28.02 | L2-L3 | Right | 2 | NO | ||
MS | 68 | M | 80 | 170 | 27.68 | L4-L5 | Right | 60 | 3 | NO | |
MA | 81 | M | 86 | 169 | 30.11 | L2-L3 | Left | 100 | 2 | NO | |
MD | 72 | M | 60 | 165 | 22.04 | L5-S1 | Left | 97 | 2 | NO | |
MC | 66 | F | 78 | 165 | 28.65 | L4-L5 | Left | 60 | 1 | NO | |
NE | 57 | M | 72 | 170 | 24.91 | L3-L4 | Right | 47 | 1 | NO | |
NC | 57 | F | 70 | 160 | 27.34 | L4-L5 | Right | 70 | 0.75 | NO | |
NG | 50 | M | 64 | 170 | 22.15 | L5-S1 | Left | 69 | 3 | NO | |
PS | 63 | M | 75 | 170 | 25.95 | L3-L4 | Left | 105 | 6 | NO | |
PM | 53 | M | L5-S1 | Right | 70 | 1 | NO | ||||
PG | 62 | F | 78 | 170 | 26.99 | L2-L3 | Left | 65 | 1 | NO | |
PA | 75 | F | 73 | 160 | 28.52 | L3-L4 | Left | 40 | 2.5 | NO | |
RL | 81 | M | 82 | 170 | 28.37 | L3-L4 | Right | 75 | 1 | NO | |
RS | 42 | M | 122 | 178 | 38.51 | L4-L5 | Right | 75 | 5 | NO | |
RD | 60 | F | 55 | 160 | 21.48 | L5-S1 | Left | 65 | 6 | NO | |
SE | 78 | F | 58 | 160 | 22.66 | L4-L5 | Left | 65 | 6 | NO | |
SE | 69 | M | 70 | 170 | 24.22 | L4-L5 | Right | 60 | 2.5 | NO | |
SM | 46 | M | 63 | 170 | 21.80 | L5-S1 | Right | 75 | 0.25 | NO | |
SS | 57 | M | 64 | 180 | 19.75 | L4-L5 | Left | 110 | 2 | NO | |
SR | 57 | F | 56 | 167 | 20.08 | L2-L3 | Right | 144 | 3 | NO | |
SG | 62 | M | 66 | 175 | 21.55 | L3-L4 | Right | 68 | 1.5 | NO | |
SM | 57 | M | 74 | 178 | 23.36 | L3-L4 | Right | 85 | 3 | NO | |
TL | 51 | M | 100 | 180 | 30.86 | L2-L3 | Right | 115 | 0.5 | NO | |
TG | 64 | M | 83 | 180 | 25.62 | L4-L5 | Left | 95 | 0.5 | NO | |
TL1 | 62 | M | 87 | 183 | 25.98 | L3-L4 | Right | 40 | 1 | NO | |
TE | 74 | F | 73 | 182 | 22.04 | L2-L3 | Left | 55 | 0.5 | NO | |
VF | 67 | M | 93 | 185 | 27.17 | L3-L4 | Right | 85 | 5 | NO | |
ZF | 60 | M | 105 | 173 | 35.08 | L3-L4 | Left | 87 | 2 | NO | |
ZE | 59 | M | L2-L3 | Left | 105 | 1 | NO | ||||
ZI | 80 | M | 56 | 155 | 23.31 | L2-L3 | Left | 65 | 3 | NO | |
GL | 56 | M | 57 | 155 | 23.73 | L4-L5 | Right | 60 | 1.5 | NO | |
BM | 61 | F | 64 | 160 | 25.00 | L3-L4 | Left | 65 | 3 | NO | |
YT | 68 | M | 74 | 170 | 25.61 | L3-L4 | Right | 85 | 24 | NO | |
ZM | 58 | M | 66 | 170 | 22.84 | L5-S1 | Left | 59 | 2 | NO | |
FA | 51 | M | 83 | 183 | 24.78 | L2-L3 | Left | 80 | 0.5 | NO | |
SM | 74 | M | 80 | 175 | 26.12 | L2-L3 | Right | 39 | 0.25 | NO | |
SL | 50 | F | 86 | 160 | 33.59 | L4-L5 | Right | 79 | 1 | NO | |
ZR | 63 | M | 77 | 171 | 26.33 | L4-L5 | Left | 72 | 2 | NO | |
VR | 53 | M | 80 | 178 | 25.25 | L3-L4 | Left | 45 | 1 | NO | |
GV | 61 | F | 64 | 164 | 23.80 | L4-L5 | Left | 90 | 2 | NO | |
CM | 59 | F | 80 | 162 | 30.48 | L2-L3 | Left | 70 | 2 | NO | |
CP | 79 | M | 60 | 165 | 22.04 | L4-L5 | Right | 110 | 2 | NO | |
FR | 47 | M | 67 | 164 | 24.91 | L4-L5 | Right | 90 | 24 | NO | |
GS | 51 | M | 67 | 163 | 25.22 | L4-L5 | Right | 39 | 1.5 | NO | |
MG | 69 | M | 90 | 174 | 29.73 | L3-L4 | Right | 45 | 0.5 | NO | |
BP | 71 | M | 74 | 168 | 26.22 | L4-L5 | Right | 80 | 3 | NO | |
CR | 48 | F | 85 | 159 | 33.62 | L2-L3 | Right | 70 | 8 | NO | |
CC | 49 | M | 93 | 178 | 29.35 | L4-L5 | Left | 70 | 2 | NO | |
BR | 51 | F | 80 | 159 | 31.64 | L2-L3 | Right | 50 | 2 | NO | |
BF | 49 | F | 60 | 165 | 22.04 | L3-L4 | Right | 95 | 5 | NO | |
PG | 76 | M | 88 | 176 | 28.41 | L4-L5 | Right | 70 | 1 | NO | |
DM | 42 | M | 75 | 166 | 27.22 | L4-L5 | Left | 65 | 3 | YES | 18 |
CGL | 53 | M | 80 | 182 | 24.15 | L3-L4 | Right | 64 | 1 | NO | |
BI | 70 | M | 62 | 169 | 21.71 | L4-L5 | Left | 45 | 0.5 | NO | |
DL | 70 | M | 86 | 180 | 26.54 | L3-L4 | Right | 90 | 3 | NO | |
FG | 67 | M | 72 | 161 | 27.78 | L4-L5 | Right | 90 | 0.25 | NO | |
FV | 58 | M | 80 | 176 | 25.83 | L5-S1 | Left | 100 | 2 | NO | |
SL | 60 | M | 90 | 177 | 28.73 | L4-L5 | Right | 100 | 0.5 | NO | |
BM | 48 | F | 52 | 175 | 16.98 | L4-L5 | Right | 60 | 1 | NO | |
PG | 47 | M | 63 | 173 | 21.05 | L3-L4 | Right | 65 | 2 | NO | |
SL | 56 | M | 110 | 178 | 34.72 | L4-L5 | Right | 110 | 3 | NO | |
PG | 60 | M | 100 | 173 | 33.41 | L2-L3 | Left | 80 | 2 | NO | |
CA | 52 | F | 72 | 172 | 24.34 | L4-L5 | Right | 105 | 1 | NO | |
VM | 48 | M | 65 | 190 | 18.01 | L3-L4 | Right | 135 | 12 | YES | 4 |
CA | 80 | M | 79 | 173 | 26.40 | L4-L5 | Right | 160 | 12 | NO | |
IC | 65 | F | 73 | 158 | 29.24 | L4-L5 | Right | 16 | 2 | NO | |
CA | 70 | F | 59 | 167 | 21.16 | L4-L5 | Left | 70 | 12 | NO | |
CF | 73 | F | 70 | L4-L5 | Left | 130 | 3.5 | NO | |||
RE | 61 | M | 90 | 177 | 28.73 | L3-L4 | Right | 90 | 2 | NO | |
VA | 62 | F | 53 | 159 | 20.96 | L3-L4 | Right | 58 | 12 | NO | |
AMA | 64 | F | 65 | 161 | 25.08 | L2-L3 | Right | 40 | 3 | NO | |
FP | 68 | M | 80 | 175 | 26.12 | L4-L5 | Left | 103 | 5 | NO | |
SR | 73 | M | 101 | 183 | 30.16 | L4-L5 | Right | 153 | 8 | YES | 7 |
SO | 66 | F | 65 | 166 | 23.59 | L4-L5 | Right | 43 | 3 | NO | |
DR | 78 | M | 80 | 175 | 26.12 | L4-L5 | Right | 35 | 2 | NO | |
ZE | 25 | M | 76 | 178 | 23.99 | L5-S1 | Right | 60 | 3 | NO | |
GB | 81 | M | 63 | 160 | 24.61 | L3-L4 | Right | 80 | 18 | NO | |
RMA | 59 | F | 79 | 162 | 30.10 | L4-L5 | Left | 94 | 2 | NO | |
MR | 75 | M | 86 | 175 | 28.08 | L4-L5 | Left | 85 | 7 | NO | |
SB | 52 | M | 84 | 183 | 25.08 | L3-L4 | Right | 168 | 1 | NO | |
PV | 56 | M | 68 | 168 | 24.09 | L5-S1 | Right | 50 | 4 | YES | 20 |
CA | 54 | F | 70 | 170 | 24.22 | L5-S1 | Right | 105 | 3 | NO | |
GV | 70 | M | 102 | 183 | 30.46 | L2-L3 | Right | 150 | 2 | NO | |
AN | 52 | F | 88 | 168 | 31.18 | L3-L4 | Left | 45 | 2 | NO | |
FM | 51 | M | 91 | 181 | 27.78 | L3-L4 | Right | 45 | 2 | NO | |
DAA | 48 | M | 90 | 165 | 33.06 | L5-S1 | Left | 85 | 12 | NO | |
PA | 49 | F | 57 | 160 | 22.27 | L4-L5 | Right | 34 | 94 | NO | |
ZD | 66 | F | 61 | 158 | 24.44 | L4-L5 | Left | 57 | 2 | NO | |
GI1 | 72 | F | 75 | 156 | 30.82 | L3-L4 | Left | 35 | 7 | NO | |
PF | 71 | M | 68 | 182 | 20.53 | L4-L5 | Right | 40 | 1 | NO | |
CV | 47 | M | 93 | 178 | 29.35 | L4-L5 | Right | 100 | 3 | NO | |
FAM | 63 | F | 80 | 160 | 31.25 | L5-S1 | Right | 55 | 2 | NO | |
GM | 57 | M | 78 | 182 | 23.55 | L4-L5 | Right | 55 | 2 | NO | |
AG | 80 | M | 62 | 165 | 22.77 | L4-L5 | Right | 45 | 3 | NO | |
BG | 67 | M | 80 | 165 | 29.38 | L4-L5 | Right | 69 | 2 | NO | |
VC | 54 | M | 105 | 186 | 30.35 | L4-L5 | Right | 70 | 2 | NO | |
GR | 67 | F | 77 | 170 | 26.64 | L4-L5 | Right | 95 | 3 | NO | |
ZC | 57 | F | 59 | 165 | 21.67 | L4-L5 | Left | 30 | 3 | NO | |
FF | 38 | M | 75 | 177 | 23.94 | L5-S1 | Right | 29 | 5 | NO | |
ZP | 45 | M | 100 | 178 | 31.56 | L3-L4 | Right | 60 | 15 | NO | |
ZC | 57 | F | 60 | 165 | 22.04 | L4-L5 | Left | 42 | 4 | NO | |
LE | 57 | M | 78 | 173 | 26.06 | L3-L4 | Left | 75 | 3 | NO | |
PA | 45 | M | 70 | 175 | 22.86 | L3-L4 | Right | 75 | 2 | NO | |
PN | 72 | M | 90 | 160 | 35.16 | L4-L5 | Right | 178 | 13 | NO | |
BN | 48 | M | 101 | 185 | 29.51 | L2-L3 | Left | 99 | 2 | NO | |
SD | 58 | M | 75 | 175 | 24.49 | L4-L5 | Right | 73 | 15 | NO | |
MV | 82 | M | 100 | 167 | 35.86 | L3-L4 | Right | 50 | 0.5 | NO | |
CM | 75 | M | 65 | 163 | 24.46 | L5-S1 | Left | 220 | 5 | YES | 5 |
ID PAT | Junctional herniation | Junctional herniation time (months) | Pre OP deficit | Deficit pre OP STAT NO = 0, YES = 1 | DEFICIT RECOVERY | Recovery NO = 0, YES FULL = 1, YES PARTIAL = 2 | Pre OP pain radicular pain | Pre OP pain-radicular pain (NRS) | Post OP radicular pain | Post OP PAIN NO = 0, YES decreased = 1, YES unchanged = 2, low back pain = 3 | |
---|---|---|---|---|---|---|---|---|---|---|---|
AA | NO | NO | 0 | YES | 10 | NO | 0 | 0 | |||
BD | NO | YES (left thigh adduction 4+/5) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
BR | NO | YES (thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
BAM | NO | YES (left anterior tibial deficit + left thigh strength deficit 4+/5) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
BL | NO | YES (left anterior tibial deficit (4/5)) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
BM | NO | YES (thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
BG | NO | YES (thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
CS | NO | NO | 0 | YES | 10 | NO | 0 | 0 | |||
CG | NO | YES (right tibial anterior deficit) | 1 | YES full | 1 | YES | 10 | NO | 0 | 0 | |
CC | NO | NO | 0 | YES | 10 | NO | 0 | 0 | |||
CS | NO | YES (thigh strength deficit) | 1 | YES full | 1 | YES | 10 | NO | 0 | 0 | |
CR | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
FS | NO | YES (thigh strength deficit) | 1 | YES full | 1 | YES | 6 | NO | 0 | 0 | |
FE | NO | YES (thigh strength deficit) | 1 | YES full | 1 | YES | 6 | NO | 0 | 0 | |
GR | NO | YES (thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
GE | YES | 33 | NO | 0 | YES | 8 | NO | 0 | 0 | ||
GD | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
GI | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
GI1 | NO | YES (thigh strength deficit + left tibial anterior deficit) | 1 | YES full | 1 | YES | 6 | NO | 0 | 0 | |
LF | NO | YES (thigh strength deficit) | 1 | YES partial | 2 | YES | 9 | NO | 0 | 0 | |
LL | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
LG | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
MM | NO | YES (thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
MM1 | NO | NO | 0 | YES | 10 | NO | 0 | 0 | |||
MN | NO | YES (left thigh strength deficit) | 1 | YES partial | 2 | YES | 7 | NO | 0 | 0 | |
MMG | NO | NO | 0 | YES | 7 | NO | 0 | 0 | |||
MD | NO | NO | 0 | YES | 7 | NO | 0 | 0 | |||
MD | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
MS | NO | YES (right thigh strength deficit) | 1 | YES partial | 2 | YES | 8 | NO | 0 | 0 | |
MA | NO | YES left hip flexion deficit | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
MD | NO | YES (left anterior tibial deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
MC | NO | YES (left anterior tibial deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
NE | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
NC | NO | YES (right tibialis anterior deficit) | 1 | YES partial | 2 | YES | 9 | NO | 0 | 0 | |
NG | NO | YES (left anterior tibialis deficit) | 1 | YES partial | 2 | YES | 6 | NO | 0 | 0 | |
PS | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
PM | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
PG | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
PA | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
RL | NO | NO | 0 | YES | 7 | NO | 0 | 0 | |||
RS | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
RD | NO | YES (deficit in left foot flexion) | 1 | YES full | 1 | YES | 10 | NO | 0 | 0 | |
SE | NO | YES (left tibialis anterior deficit) | 1 | YES full | 1 | YES | 10 | NO | 0 | 0 | |
SE | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
SM | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
SS | NO | YES (left tibialis anterior deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
SR | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
SG | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
SM | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
TL | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 7 | NO | 0 | 0 | |
TG | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
TL1 | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
TE | NO | YES left hip flexion deficit | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
VF | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
ZF | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
ZE | NO | NO | 0 | YES | 7 | NO | 0 | 0 | |||
ZI | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
GL | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
BM | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
YT | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
ZM | NO | YES (right tibialis anterior deficit) | 1 | YES partial | 2 | YES | 8 | NO | 0 | 0 | |
FA | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
SM | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
SL | NO | NO | 0 | YES | 10 | NO | 0 | 0 | |||
ZR | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 6 | NO | 0 | 0 | |
VR | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
GV | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
CM | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
CP | YES | 30 | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | Low back pain | Low back pain | 3 |
FR | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 9 | Low back pain | Low back pain | 3 | |
GS | NO | YES (right tibialis anterior deficit) | 1 | YES partial | 2 | YES | 9 | Low back pain | Low back pain | 3 | |
MG | NO | NO | 0 | YES | 9 | Low back pain | Low back pain | 3 | |||
BP | NO | NO | 0 | YES | 7 | Low back pain | Low back pain | 3 | |||
CR | NO | YES right hip flexion deficit | 1 | YES full | 1 | YES | 8 | Low back pain | Low back pain | 3 | |
CC | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
BR | NO | YES right hip flexion deficit | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
BF | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
PG | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
DM | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 7 | NO | 0 | 0 | |
CGL | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
BI | NO | NO | 0 | YES | 9 | YES | 6 | 1 | |||
DL | NO | NO | 0 | YES | 8 | Low back pain | Low back pain | 3 | |||
FG | NO | NO | 0 | YES | 8 | YES | 5 | 1 | |||
FV | NO | YES (left anterior tibialis deficit) | 1 | YES partial | 2 | YES | 8 | YES | 4 | 1 | |
SL | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 8 | Low back pain | Low back pain | 3 | |
BM | NO | YES (right tibialis anterior deficit) | 1 | NO | 0 | YES | 8 | YES | 3 | 1 | |
PG | NO | YES (right thigh strength deficit) | 1 | NO | 0 | YES | 10 | YES | 5 | 1 | |
SL | NO | NO | 0 | YES | 6 | YES | 3 | 1 | |||
PG | NO | YES right hip flexion deficit | 1 | YES partial | 2 | YES | 9 | Low back pain | Low back pain | 3 | |
CA | NO | NO | 0 | YES | 8 | Low back pain | Low back pain | 3 | |||
VM | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
CA | NO | YES (right thigh strength deficit) | 1 | NO | 0 | YES | 9 | YES unchanged | 9 | 2 | |
IC | NO | NO | 0 | YES | 9 | YES | 3 | 1 | |||
CA | NO | NO | 0 | YES | 9 | YES | 4 | 1 | |||
CF | NO | NO | 0 | YES | 9 | YES | 2 | 1 | |||
RE | YES | 10 | YES (right thigh strength deficit) | 1 | YES partial | 2 | YES | 10 | YES | 4 | 1 |
VA | NO | NO | 0 | YES | 9 | YES | 3 | 1 | |||
AMA | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 9 | YES | 4 | 1 | |
FP | NO | NO | 0 | YES | 7 | NO | 0 | 0 | |||
SR | NO | YES (right tibialis anterior deficit + right thigh strength deficit) | 1 | YES partial | 2 | YES | 7 | Low back pain | Low back pain | 3 | |
SO | NO | YES (left tibialis anterior deficit) | 1 | YES full | 1 | YES | 9 | Low back pain | Low back pain | 3 | |
DR | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 8 | Low back pain | Low back pain | 3 | |
ZE | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 6 | NO | 0 | 0 | |
GB | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
RMA | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 9 | YES | 3 | 1 | |
MR | NO | YES (left tibialis anterior deficit) | 1 | YES full | 1 | YES | 8 | YES | 5 | 1 | |
SB | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
PV | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 8 | YES | 4 | 1 | |
CA | NO | YES (deficit in right foot flexion) | 1 | YES partial | 2 | YES | 8 | NO | 0 | 0 | |
GV | NO | YES right hip flexion deficit | 1 | YES full | 1 | YES | 8 | YES | 5 | 1 | |
AN | NO | YES (left anterior tibial deficit + left thigh strength deficit ) | 1 | YES full | 1 | YES | 9 | YES unchanged | 9 | 2 | |
FM | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | YES | 3 | 1 | |
DAA | NO | YES (left tibialis anterior deficit) | 1 | YES full | 1 | YES | 9 | YES | 4 | 1 | |
PA | NO | YES (right tibialis anterior deficit) | 1 | YES partial | 2 | YES | 9 | NO | 0 | 0 | |
ZD | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 10 | NO | 0 | 0 | |
GI1 | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
PF | NO | YES (left anterior tibial deficit + left thigh strength deficit ) | 1 | YES full | 1 | YES | 9 | YES | 4 | 1 | |
CV | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 7 | NO | 0 | 0 | |
FAM | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 7 | YES | 3 | 1 | |
GM | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
AG | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
BG | NO | YES (right thigh strength deficit) | 1 | YES partial | 2 | YES | 6 | NO | 0 | 0 | |
VC | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 8 | YES | 4 | 1 | |
GR | NO | YES (right tibialis anterior deficit + right thigh strength deficit) | 1 | YES partial | 2 | YES | 9 | YES | 3 | 1 | |
ZC | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
FF | NO | YES (deficit in left foot flexion) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
ZP | NO | NO | 0 | YES | 8 | NO | 0 | 0 | |||
ZC | NO | YES (left thigh strength deficit) | 1 | YES full | 1 | YES | 8 | NO | 0 | 0 | |
LE | NO | YES (left thigh strength deficit) | 1 | YES partial | 2 | YES | 8 | Low back pain | Low back pain | 3 | |
PA | NO | YES (right thigh strength deficit) | 1 | YES partial | 2 | YES | 8 | YES | 3 | 1 | |
PN | NO | YES (right thigh strength deficit) | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
BN | NO | YES left hip flexion deficit | 1 | YES full | 1 | YES | 9 | NO | 0 | 0 | |
SD | NO | NO | 0 | YES | 9 | NO | 0 | 0 | |||
MV | NO | YES (right tibialis anterior deficit + right thigh strength deficit) | 1 | YES partial | 2 | YES | 7 | NO | 0 | 0 | |
CM | NO | YES (right tibialis anterior deficit) | 1 | YES full | 1 | YES | 10 | NO | 0 | 0 |
Statistical analysis
Results
Demographic characteristics
Clinical characteristics
Outcomes
Age | Sex | BMI | Level | |
---|---|---|---|---|
Recurrent herniation | 0.638 | 0.408 | 0.879 | 0.239 |
Junctional herniation | 0.571 | 0.334 | 0.519 | 0.685 |
Recurrence or junctional | 0.528 | 0.180 | 0.743 | 0.640 |
95% CI per EXP (B) | ||||
---|---|---|---|---|
Variables | p value | OR | Inferior | Superior |
Age | 0.651 | 1349 | 0.331 | 5870 |
Sex | 0.253 | 3502 | 0.408 | 30,083 |
BMI (≤24.9) | 0.853 | |||
BMI (=25/≤29.9) | 0.924 | 0.928 | 0.201 | 4285 |
BMI (≥30) | 0.580 | 0.523 | 0.053 | 5191 |
Level (L2/L3/−L3/L4) | 0.730 | |||
Level (L4/L5) | 0.842 | 0.245 | 0.245 | 5622 |
Level (L5/S1) | 0.439 | 0.303 | 0.303 | 15,665 |
Discussion
Authors | Year | Journal | Title | Primary outcome | N. of patients | N. of recurrences | Conclusion | Reference | Observations |
---|---|---|---|---|---|---|---|---|---|
Chang SB et al. | 2006 | Spine | Risk factor for unsatisfactory outcome after lumbar foraminal and far lateral microdecompression | To evaluate the risk factors for unsatisfactory outcome. | 184 | 6 | Facet preserving microdecompression is an effective method for foraminal and far lateral root compression. However, in cases of double herniation, total facetectomy is preferable. | Chang SB, Lee SH, Ahn Y, Kim JM. Risk factor for unsatisfactory outcome after lumbar foraminal and far lateral microdecompression. Spine (Phila Pa 1976). 2006 May 1;31(10):1163-7. doi: 10.1097/01.brs.0000216431.69359.91. PMID: 16648754. | |
Porchet F | 1999 | Journal of Neurosurgery | Long-term follow up of patients surgically treated by the far-lateral approach for foraminal and extraforaminal lumbar disc herniations | To evaluate the long-term benefit in 202 patients who were surgically treated via a microsurgical far-lateral approach for foraminal or extraforaminal lumbar disc herniations. | 202 | 11 | The far-lateral approach is a safe, effective procedure that avoids the risk of secondary spinal instability. | Porchet F, Chollet-Bornand A, de Tribolet N. Long-term follow up of patients surgically treated by the far-lateral approach for foraminal and extraforaminal lumbar disc herniations. J Neurosurg. 1999 Jan;90(1 Suppl):59-66. doi: 10.3171/spi.1999.90.1.0059. PMID: 10413127. | |
Kotil K et al. | 2007 | Journal of Spinal disorders and technique | A minimally invasive transmuscular approach to far-lateral L5-S1 level disc herniations: a prospective study | To assess the efficacy of a surgical technique that is a minimally invasive intermuscular approach (MIIMA) for decompression of L5-S1 far-lateral level disc herniation (FLLDH). | 28 | 0 | The MIIMA procedure provides a simple alternative for treating lumbar foraminal or lateral exit zone herniated discs in selected cases. This approach is effective, allowing the preservation of the L5-S1 facet joint, saving the facet joint, preventing postoperative instability, and offering a direct view of the L5-S1 neuroforamen. | Kotil K, Akcetin M, Bilge T. A minimally invasive transmuscular approach to far-lateral L5-S1 level disc herniations: a prospective study. J Spinal Disord Tech. 2007 Apr;20(2):132-8. doi: 10.1097/01.bsd.0000211268.43744.2a. PMID: 17414982. | |
Sasani M et al. | 2007 | Minimally Invasive Neurosurgery | Percutaneous endoscopic discectomy for far lateral lumbar disc herniations: prospective study and outcome of 66 patients | To study the outcome of PED for treatment of foraminal or extraforaminal disc herniation | 66 | 1 | Percutaneous endoscopic discectomy is a minimally invasive method and offers many benefits to the patient, but extensive surgical practice is needed to become a capable surgeon. Consequently this technique can only be a treatment option on appropriate patients. This study reconfirmed that the removal of fragmented disc material is achieved and offers a pain-free status | Sasani M, Ozer AF, Oktenoglu T, Canbulat N, Sarioglu AC. Percutaneous endoscopic discectomy for far lateral lumbar disc herniations: prospective study and outcome of 66 patients. Minim Invasive Neurosurg. 2007 Apr;50(2):91-7. doi: 10.1055/s-2007-984383. PMID: 17674295. | |
Teli M et al. | 2010 | European Spine Journal | Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy | To investigate the hypothesis of different outcomes and complications obtainable with the three techniques. | 240 | 13 | Outcome measures are equivalent 2 years following lumbar discectomy with micro-endoscopy, microscopy or open technique, but severe complications are more likely and costs higher with micro-endoscopy. | Teli M, Lovi A, Brayda-Bruno M, Zagra A, Corriero A, Giudici F, Minoia L. Higher risk of dural tears and recurrent herniation with lumbar micro-endoscopic discectomy. Eur Spine J. 2010 Mar;19(3):443-50. doi: 10.1007/s00586-010-1290-4. Epub 2010 Feb 3. PMID: 20127495; PMCID: PMC2899770. | Three techniques: micro-endoscopic, micro, open discectomy |
Lübbers T et al. | 2012 | Acta Neurochirurgica | Percutaneous endoscopic treatment of foraminal and extraforaminal disc herniation at the L5-S1 level | To present the outcome of percutaneous endoscopic lumbar discectomy (PELD) of these lateral and far lateral disc herniations at the L5-S1 level using the newly described foraminal retreat technique in a group of patients with similar preoperative diagnostic studies. | 22 | 2 | Percutaneous endoscopic discectomy using the foraminal retreat technique is an effective treatment method for patients with foraminal and extraforaminal disc herniations at the L5-S1 level on appropriately selected patients. | Lübbers T, Abuamona R, Elsharkawy AE. Percutaneous endoscopic treatment of foraminal and extraforaminal disc herniation at the L5-S1 level. Acta Neurochir (Wien). 2012 Oct;154(10):1789-95. doi: 10.1007/s00701-012-1432-z. Epub 2012 Jul 11. PMID: 22782651. | |
Choi KC et al. | 2013 | Pain Physician | Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation: transforaminal versus interlaminar approach | To compare the radiologic features and results of TF-PELD and IL-PELD. We have clarified the patient selection for the PELD route for L5-S1 disc herniation. | 30 | 3.3% TF-PELD; 6.7% IL-PELD | This study demonstrated that TF-PELD is preferred for shoulder type, centrally located, and recurrent disc herniation, while IL-PELD is preferred for axillary type and migrated discs, especially those of a high grade. | Choi KC, Kim JS, Ryu KS, Kang BU, Ahn Y, Lee SH. Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation: transforaminal versus interlaminar approach. Pain Physician. 2013 Nov-Dec;16(6):547-56. PMID: 24284840. | |
Yokosuka J et al. | 2016 | Journal of Spine Surgery | Advantages and disadvantages of posterolateral approach for percutaneous endoscopic lumbar discectomy | To focus the posterolateral approach (PLA) and investigate the appropriate operative indication | 29 | 1 | PLA can be safely used to treat foraminal and extraforaminal LDH with foraminal height ≥13 mm and foraminal width ≥7 mm. The procedure is effective for preserving the facet joint; however, we should carefully consider the indications when local scoliosis and/or instability are present. | Yokosuka J, Oshima Y, Kaneko T, Takano Y, Inanami H, Koga H. Advantages and disadvantages of posterolateral approach for percutaneous endoscopic lumbar discectomy. J Spine Surg. 2016 Sep;2(3):158-166. doi: 10.21037/jss.2016.09.03. PMID: 27757427; PMCID: PMC5067274. | |
Choi KC et al. | 2017 | World Neurosurgery | Usefulness of Percutaneous Endoscopic Lumbar Foraminoplasty for Lumbar Disc Herniation | To evaluate the efficacy of foraminoplasty for HD and propose applicable situations for foraminoplasty in PELD. | 136 | 4 (1 FG, 3 NFG) | Percutaneous endoscopic lumbar foraminoplasty may be effective for small DH, migration, sequestration, recurrent HD, HD in L5-S1 with a high iliac crest, and central HD with a wide lamina angle. | Choi KC, Shim HK, Park CJ, Lee DC, Park CK. Usefulness of Percutaneous Endoscopic Lumbar Foraminoplasty for Lumbar Disc Herniation. World Neurosurg. 2017 Oct;106:484-492. doi: 10.1016/j.wneu.2017.07.035. Epub 2017 Jul 16. PMID: 28720527. | FG: foraminoplasty group; NFG: non foraminoplasty group |
De Bonis P et al. | 2017 | Spine | Transpars Microscopic Approach for the Treatment of Purely Foraminal Herniated Lumbar Disc: A Clinical, Radiological, Two-center Study | To assess the safety and efficacy of treating patients with lumbar foraminal disc herniations via a microscopic transpars approach, with a clinical and radiological follow-up evaluation. | 47 | 0 | Transpars microscopic approach is effective and safe for the treatment of FLDH. | De Bonis P, Mongardi L, Pompucci A, Ricciardi L, Cavallo MA, Farneti M, Lapparelli M, Capone G, Altruda C, Schivalocchi R, Campioni P, Ghisellini G, Trapella G. Transpars Microscopic Approach for the Treatment of Purely Foraminal Herniated Lumbar Disc: A Clinical, Radiological, Two-center Study. Spine (Phila Pa 1976). 2017 Mar 15;42(6):E371-E378. doi: 10.1097/BRS.0000000000001839. PMID: 27496668. | |
Wong KW et al. | 2018 | World Neurosurgery | Clinical Outcome of Minimally Invasive Decompression Without Discectomy in Contained Foraminal Disc Herniation: A Single-Center Study | To evaluate the benefits of stand-alone decompression without discectomy for patients with contained foraminal disc herniation. | 17 | 0 | Stand-alone decompression without discectomy is an effective method for relieving symptoms and preserving the disc in contained foraminal disc herniation. A minimally invasive approach with thorough decompression techniques yields good results. | Wong KW, Ho CH, Yu TC, Wu CD, Tsang YS. Clinical Outcome of Minimally Invasive Decompression Without Discectomy in Contained Foraminal Disc Herniation: A Single-Center Study. World Neurosurg. 2018 Oct;118:e367-e374. doi: 10.1016/j.wneu.2018.06.192. Epub 2018 Jun 30. PMID: 29969734. | NOT PERTINENT |
Kim HS et al. | 2018 | Journal of Visualized Experiments | A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations | To describe the technical aspects of a novel mobile outside-in method in dealing with different types of disc prolapse. | 184 | 15 | This article presents a novel outside-in approach that relies on a precise landing within the foramen in a mobile manner and does not solely depend upon the enlargement of the foramen | Kim HS, Adsul N, Kapoor A, Choi SH, Kim JH, Kim KJ, Bang JS, Yang KH, Han S, Lim JH, Jang JS, Jang IT, Oh SH. A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations. J Vis Exp. 2018 Aug 7;(138):57999. doi: 10.3791/57999. PMID: 30148483; PMCID: PMC6126677. | NOT PERTINENT |
Bae JS et al. | 2018 | Neurocirurgia | Extreme lateral and interlaminar approach for intra-canal and foraminal double disc herniation at lumbosacral level | To compare the approach with the conventional combined interlaminar and paraisthmic approach (CIPA). | 35 | 4 (CIPA group) | In the treatment of L5-S1 double disc herniation, the ELIA surgical approach showed better outcomes than the CIPA surgical approach did with respect to pain and K-ODI during a mid-term follow-up examination conducted three months post-operation. | Bae JS, Kim KJ, Kang MS, Jang IT. Extreme lateral and interlaminar approach for intra-canal and foraminal double disc herniation at lumbosacral level. Neurocirugia (Astur : Engl Ed). 2019 Mar-Apr;30(2):53-59. English, Spanish. doi: 10.1016/j.neucir.2018.07.002. Epub 2018 Sep 28. PMID: 30274950. | Article in Spanish |
Zhang Y | 2018 | Quantitative Imaging in medicine and Surgery | The modified transforaminal endoscopic technique in treating intracanalicular combining foraminal and/or extraforaminal lumbar disc herniations | To develop a modified transforaminal endoscopic spine system (TESSYS®) technique for treating intracanalicular combining foraminal and/or extraforaminal lumbar disc herniation (ICFE-LDH), and evaluate the technical efficacy and safety. | 22 | 1 | The modified TESSYS technique is a minimally-invasive, effective and safe surgery for treating ICFE-LDHs in selected patients | Zhang Y, Pan Z, Yu Y, Zhang D, Ha Y, Yi S, Shin DA, Sun J, Koga H, Phan K, Azimi P, Huang W, Cao K; written on behalf of AME Spine Surgery Collaborative Group. The modified transforaminal endoscopic technique in treating intracanalicular combining foraminal and/or extraforaminal lumbar disc herniations. Quant Imaging Med Surg. 2018 Oct;8(9):936-945. doi: 10.21037/qims.2018.10.02. PMID: 30505722; PMCID: PMC6218206. | New minimally invasive technique to treat endoscopically the foraminal disch herniation |
Abdelgawaad AS et al. | 2018 | The Spine Journal | Extraforaminal microscopic assisted percutaneous nucleotomy for foraminal and extraforaminal lumbar disc herniations | To evaluate the clinical outcome, complications recurrence, and reoperation rate of extraforaminal microscopic-assisted percutaneous nucleotomy, with literature review focusing on complications and recurrence rate. | 76 | 2 | Trans-tubular percutaneous extraforaminal microscopic-assisted nucleotomy is effective for foraminal and extraforaminal disc herniations. It is a muscle-splitting minimally invasive approach with minimal morbidity. Complications, recurrence, and reoperation rate are not different compared with microsurgical open or endoscopic techniques. | Shawky Abdelgawaad A, Babic D, Siam AE, Ezzati A. Extraforaminal microscopic assisted percutaneous nucleotomy for foraminal and extraforaminal lumbar disc herniations. Spine J. 2018 Apr;18(4):620-625. doi: 10.1016/j.spinee.2017.08.258. Epub 2017 Sep 4. PMID: 28882526. | |
LewandrowskiKai-Uwe | 2018 | International Journal of Spine Surgery | Readmissions After Outpatient Transforaminal Decompression for Lumbar Foraminal and Lateral Recess Stenosis | To analyze readmission rates after outpatient transforaminal endoscopic decompression surgery for lumbar foraminal and lateral recess stenosis done in an ambulatory surgery center. | 1839 | 9 | Transforaminal endoscopic decompression can be successfully carried out in an outpatient surgery center setting. Readmissions due to reherniations, postoperative complications, or poor pain control are uncommon. | Lewandrowski KU. Readmissions After Outpatient Transforaminal Decompression for Lumbar Foraminal and Lateral Recess Stenosis. Int J Spine Surg. 2018 Aug 15;12(3):342-351. doi: 10.14444/5040. PMID: 30276091; PMCID: PMC6159758. | |
Park CH et al. | 2019 | Pain Physician | Risk Factors for Early Recurrence After Transforaminal Endoscopic Lumbar Disc Decompression | To identify factors correlating with early HLD recurrence after TELD. | 1900 | 209 | In patients undergoing TELD procedures, smaller-sized herniated discs are linked to early recurrences. | Park CH, Park ES, Lee SH, Lee KK, Kwon YK, Kang MS, Lee SY, Shin YH. Risk Factors for Early Recurrence After Transforaminal Endoscopic Lumbar Disc Decompression. Pain Physician. 2019 Mar;22(2):E133-E138. PMID: 30921991. | Recurrences were unrelated to gender, BMI, DM or HTN, smoking status, migration grade, nature (Dht or Dbase of herniated disc), or the presence of spondylolisthesis. |
Kim HS et al. | 2019 | BioMed Research International | Predictive Scoring and Risk Factors of Early Recurrence after Percutaneous Endoscopic Lumbar Discectomy | To predict the early recurrence after full endoscopic lumbar discectomy, we analyzed factors related to demographic factor anatomical factors, operative method, and postoperative management, and predicted the possibility of recurrence according to the scoring system. | 300 | 9.33% (11% A, 10% B, 7% C) | Early recurrence after PELD is associated with several risk factors such as BMI, degeneration scale, combined HNP, and early ambulation. If we use the predicting score, we can postulate the occurrence of early recurrence after PELD. Knowing the predictive factors prior to surgical intervention will allow us to decrease the early recurrence rate after PELD. | Kim HS, You JD, Ju CI. Predictive Scoring and Risk Factors of Early Recurrence after Percutaneous Endoscopic Lumbar Discectomy. Biomed Res Int. 2019 Nov 7;2019:6492675. doi: 10.1155/2019/6492675. PMID: 31828113; PMCID: PMC6881637. | Group A: transforaminal inside-out approach; Group B: transforaminal outside-in approach; Group C: interlaminar approach) |
De Bonis P et al. | 2020 | Journal of Neurosurgical Sciences | Transpars approach for L5-S1 foraminal and extra-foraminal lumbar disc herniations: technical note | To determine the feasibility, efficacy and safety of the transpars microscopic approach for the treatment of L5-S1 foraminal and extraforaminal lumbar disc herniation. | 14 | 0 | The trans pars microscopic approach is feasible, safe and effective for L5-S1 foraminal and extraforaminal disc herniation. During surgery, the key-point is the oblique working angle, directed caudally, parallel to L5 pedicle. The iliac crest does not seem to constitute an obstacle. | De Bonis P, Musio A, Mongardi L, Lofrese G, La Marca F, Visani J, Cavallo MA, Scerrati A. Transpars approach for L5-S1 foraminal and extra-foraminal lumbar disc herniations: technical note. J Neurosurg Sci. 2020 Dec 9. doi: 10.23736/S0390-5616.20.05165-6. Epub ahead of print. PMID: 33297610. | |
Tanaka M et al. | 2021 | Journal of Spine Surgery | Clinical Outcomes and Postoperative Radiographic Assessment of Osteoplastic Hemilaminectomy in the Treatment of Lumbar Foraminal Nerve Root Compression | To review the radiographic and clinical outcomes of osteoplastic hemilaminectomy for the treatment of lumbar foraminal nerve root compression. | 51 | 3 | Ninety-four and one percent of the patients who underwent osteoplastic hemilaminectomy achieved a significant improvement in the clinical outcomes and did not require additional surgery within 2 years following the procedure. Over a 5-year follow-up on average, 5.9% of the subjects developed postoperative lumbar segmental instability | Tanaka M, Kanayama M, Hashimoto T, Oha F, Shimamura Y, Endo T, Tsujimoto T, Hara H, Hasegawa Y, Nojiri H, Ishijima M. Clinical Outcomes and Postoperative Radiographic Assessment of Osteoplastic Hemilaminectomy in the Treatment of Lumbar Foraminal Nerve Root Compression. Spine Surg Relat Res. 2021 Feb 9;5(6):352-358. doi: 10.22603/ssrr.2020-0203. PMID: 34966860; PMCID: PMC8668207. | |
Alhashash M et al. | 2022 | Archives of Orthopedic and Trauma Surgery | Extra-laminar microscopic-assisted percutaneous nucleotomy (EL-MAPN) for the treatment of foraminal lumbar disc prolapse, a modified minimally invasive approach | In this work, a modification of the percutaneous surgical approach for removing the lumbar foraminal disc prolapse is introduced. | 50 | 2 | EL-MAPN represents a minimally invasive approach for foraminal disc prolapse removal under direct visual control avoiding injury to the facet joint or pars interarticularis. | Alhashash M, Gendy H, Shousha M. Extra-laminar microscopic-assisted percutaneous nucleotomy (EL-MAPN) for the treatment of foraminal lumbar disc prolapse, a modified minimally invasive approach. Arch Orthop Trauma Surg. 2022 Oct;142(10):2405-2411. doi: 10.1007/s00402-021-03846-8. Epub 2021 Mar 7. PMID: 33677658. |