title: [EFFECTIVENESS OF PERCUTANEOUS ENDOSCOPIC TRANSFORAMINAL DISCECTOMY FOR RECURRENT LUMBAR DISC HERNIATION].
abstract: OBJECTIVE
  To determine the feasibility and effectiveness of percutaneous endoscopic transforaminal discectomy (PETD) for recurrent lumbar disc herniation (RLDH).
  
  
  METHODS
  Between June 2009 and December 2011, 56 patients with RLDH underwent PETD after local anesthesia, including 30 males and 26 females, with a mean age of 50 years (range, 24-70 years). The involved segments were L3, 4 in 3 cases, L4, 5 in 34 cases, and L5-S1 in 19 cases. Of 56 patients, 48 suffered from ipsilateral re-herniation, and 8 suffered from contralateral re-herniation. All the patients had a mean pain-free interval of 5.5 years (range, 6 months to 27 years). The visual analogue scale (VAS) score for back pain was 6.18 ± 1.44 and the VAS score for leg pain was 7.66 ± 1.03. Postoperative effectiveness was assessed based on the VAS score and modified MacNab criteria.
  
  
  RESULTS
  The mean operation time was 60.4 minutes (range, 30-100 minutes) and the mean duration of hospital stay was 5.1 days (range, 3-6 days). All patients were followed up 28.2 months on average (range, 24-56 months). Patients obtained immediate pain relief postoperatively. The postoperative VAS scores of back and leg pain at 1 month, 3 months, 12 months, and last follow-up were significantly decreased when compared with preoperative score (P < 0.05). Based on the modified MacNab criteria, the results were excellent in 39 cases, good in 9 cases, fair in 5 cases, and poor in 3 cases at 12 months after operation, and the excellent and good rate was 85.7%. Surgery-related complications were found in 5 cases (8.9%); one patient (1.8%) suffered from recurrence at 18 months postoperatively, and the symptom was relieved after open lumbar discectomy and intervertebral fusion surgery.
  
  
  CONCLUSIONS
  PETD has several advantages in treating RLDH, such as avoiding from the old scar tissue, decreasing operation-related complications, shortening operation time, reducing trauma, and obtaining rapid postoperative recovery. This technique is feasible and effective for RLDH.
authors.forename: Zhuhai
authors.initials: Z
authors.lastname: Li
authors.lastname: Zeng Jiancheng
authors.forename: Yueming
authors.initials: Y
authors.lastname: Song
authors.forename: Qingquan
authors.initials: Q
authors.lastname: Kong
authors.forename: Xiandi
authors.initials: X
authors.lastname: Wang
authors.forename: Guo
authors.initials: G
authors.lastname: Chen
authors.forename: Hongfei
authors.initials: H
authors.lastname: Nie
authors.forename: Hushan
authors.initials: H
authors.lastname: Jiang
mesh_terms: D017586:Diskectomy / Q000379:methods*; D017587:Diskectomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D061646:Operative Time; D010147:Pain Measurement; D011184:Postoperative Period; D012008:Recurrence; D016896:Treatment Outcome