title: [Short-term effectiveness of percutaneous endoscopic spine surgery for treatment of lumbar disc herniation with posterior ring apophysis separation].
abstract: OBJECTIVE
  To investigate the feasibility and short-term effectiveness of percutaneous endoscopic spine surgery for treatment of lumbar disc herniation with posterior ring apophysis separation.
  
  
  METHODS
  Between July 2008 and January 2013, 57 patients with lumbar disc herniation and posterior ring apophysis separation were treated. There were 39 males and 18 females, aged from 13 to 46 years (mean, 26.7 years). Of 57 cases, 29 had a clear trauma history. All patients had single segmental unilateral lumbar disc herniation, and the location was at L4, 5 in 22 cases and at L5, S1 in 35 cases; there were 25 cases of lateral bone fragments and 32 cases of central cortical and cancellous fragments. While fracture located at posterior inferior edge of the vertebrae at L4 level in 9 cases and at Ls level in 8 cases, at posterior superior edge at L5 level in 13 cases and in S1 level in 27 cases. Percutaneous endoscopic surgeries were performed via interlaminar or transforaminal approach from unilaterally symptomatic side for discectomy of lumbar disc herniation and partial or complete resection of free bone fragments.
  
  
  RESULTS
  Accurate positioning was obtained in all patients during operation, and no complication of nerve root injury, hematoma formation, or dural tear occurred. The operation time was 20-85 minutes; the intraoperative fluoroscopy times were 2-15 times, and the blood loss was 3-10 mL. Postoperative radiographic examination showed that bone fragment was not removed in 16 cases, was partly removed in 32 cases, and was completely removed in 9 cases. Disc was completely removed. All patients were followed up 10-64 months (median, 16 months). According to modified Macnab criteria for the evaluation of effectiveness, the results were excellent in 48 cases, good in 6 cases, and fair in 3 cases, and the excellent and good rate was 94.7%.
  
  
  CONCLUSIONS
  Percutaneous endoscopic spine surgery through unilaterally symptomatic approach has advantages of small tissue damage and lumbar structure damage, less bleeding, and shorter recovery time. It has a good short-term effectiveness, but long-term effectiveness need further follow-up.
authors: Yunzhou
authors: Y
authors: Zuo
authors: Qingquan
authors: Q
authors: Kong
authors: Xiaolong
authors: X
authors: Li
authors: Lian
authors: L
authors: Xu
authors: Shuai
authors: S
authors: Hu
authors: Jianchen
authors: J
authors: Zeng
authors: Yueming
authors: Y
authors: Song
mesh_terms: D017587:Diskectomy, Percutaneous / Q000009:adverse effects* / Q000379:methods; D004724:Endoscopy; D005260:Female; D005471:Fluoroscopy; D050723:Fractures, Bone; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009192:Myelography; D061646:Operative Time; D059348:Peripheral Nerve Injuries; D011184:Postoperative Period; D019736:Prostheses and Implants; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications* / Q000601:surgery; D013131:Spine / Q000601:surgery; D016896:Treatment Outcome