title: Transpars Microscopic Approach for the Treatment of Purely Foraminal Herniated Lumbar Disc: A Clinical, Radiological, Two-center Study.
abstract: METHODS
  This is a prospective two-center study.
  
  
  OBJECTIVE
  The aim of this study was 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.
  
  
  BACKGROUND
  Purely foraminal lumbar disc herniations comprise about 5% of all lumbar herniated intervertebral discs. Operative management can be technically difficult, and the optimum surgical treatment remains controversial.
  
  
  METHODS
  From January 2012 to January 2015, 47 patients were prospectively recruited. Patients were followed-up as outpatients at 1 week after discharge, then at 1, 6, and 12 months.A clinical multiparametric evaluation of patients including numeric rating scale (NRS), drugs intake, Macnab criteria, and working days lost was used.Postoperative dynamic x-rays (flexion, extension) were performed in all cases 12 months after surgery.
  
  
  RESULTS
  No surgery-related complications occurred.Among the 35 patients who were not retired at the time of the study, 29 patients returned to work and to normal daily activities within 60 days after surgery.Pain evaluation at discharge showed a significant improvement of NRS score, from 8.93 to 1.45 at 12 months. Root palsy significantly improved in all cases already at 1-month follow-up. Drugs intake analysis showed that at 6-month follow-up, no patients used steroids, or opioids, 17 patients used non-steroidal anti-inflammatory drugs when needed, and 29 patients (61.7%) used no drugs for pain relief. No significant variations occurred at 12-month-follow-up.At 12-month follow-up, excellent or good outcome (following Macnab criteria) was achieved in 36 (76.6%) and 8 (17%) patients, respectively.There were no cases of spinal instability at 12-month radiological evaluation.No recurrence occurred at follow-up.
  
  
  CONCLUSIONS
  Transpars microscopic approach is effective and safe for the treatment of FLDH, but larger studies are needed.
  
  
  METHODS
  3.
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
authors: Pasquale
authors: P
authors: De Bonis
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
authors: Lorenzo
authors: L
authors: Mongardi
authors: Neurotrauma, Catholic University School of Medicine, Rome, Italy.
authors: Angelo
authors: A
authors: Pompucci
authors: Neurotrauma, Catholic University School of Medicine, Rome, Italy.
authors: Luca
authors: L
authors: Ricciardi
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
authors: Michele Alessandro
authors: MA
authors: Cavallo
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
authors: Marco
authors: M
authors: Farneti
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
authors: Marcello
authors: M
authors: Lapparelli
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
authors: Gennaro
authors: G
authors: Capone
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
authors: Carmela
authors: C
authors: Altruda
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
authors: Roberta
authors: R
authors: Schivalocchi
authors: Department of Radiology, S. Anna University Hospital, Ferrara, Italy.
authors: Paolo
authors: P
authors: Campioni
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.|Department of Neurosurgery, Università Politecnica delle Marche, Umberto I University Hospital, Ancona, Italy.
authors: Giulia
authors: G
authors: Ghisellini
authors: Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.
authors: Giorgio
authors: G
authors: Trapella
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D011184:Postoperative Period; D011446:Prospective Studies; D011859:Radiography / Q000379:methods; D016896:Treatment Outcome