Transforaminal endoscopic system technique for discogenic low back pain: A prospective Cohort study.
OBJECTIVE
To investigate the clinical outcomes of transforaminal endoscopic system(TESSYS) for discogenic low back pain(DLBP).


METHODS
62 consecutive patients with one-level DLBP applying to the including criteria underwent TESSYS from January 2010 to December 2013. These patients included 38 males and 24 females with a mean age of 42.7 ± 5.4 years (range, 18-73 yr) and a mean follow-up of 26.8 ± 4.2 months (range, 12-48 months). The visual analog scale (VAS) were used for back pain, the Oswestry Disability Index (ODI) for lumbar function, and the modified MacNab criteria for clinical global outcomes.


RESULTS
24 patients showed only inflammatory granuloma on annulus tear tissues(Group A), 16 patients showed no annulus tear but adhesion and inflammatory granuloma among the intracanal annulus fibrous(AF), posterior longitudinal ligament(PLL) and the abdomen side of the dura sac(Group B) and 22 patients showed both(Group C). Concordant pain could be triggered by touching the inflammation with the bipolar radiofrequency probe. The success rate (excellent and good) of group C was much higher than A and B(P < 0.05). The whole success rate was 75.8%. Of the 4 patients with poor result, 2 refused further surgical treatment and showed either no improvement or worsening. The remaining 2 patients had spinal fusion surgery and achieved better results. VAS and ODI had significantly improved after surgery (P < 0.01). No unexpected complications were seen.


CONCLUSIONS
TEEYS is an effective method in treating DLBP and the complete management of the inflammatory granuloma was the key point in achieving better results.
Dept. of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China.
Fumin
F
Pan
Dept. of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China.
Bin
B
Shen
Dept. of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China.
Surendra K
SK
Chy
Dept. of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China.
Zhiyao
Z
Yong
Dept. of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China.
Xiaoming
X
Liu
Dept. of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China.
Zhaoyu
Z
Ba
Dept. of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China.
Zhonghan
Z
Liu
Dept. of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China. Electronic address: neverbedoc@icloud.com.
Jianguang
J
Zhu
Dept. of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China. Electronic address: eastspinesci@163.com.
Desheng
D
Wu
D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006099:Granuloma / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications* / Q000000981:diagnostic imaging; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
Discogenic low back pain; Endoscopic discectomy; Inflammation; Thermal annuloplasty