title: Surgical Outcome of Two-Level Transforaminal Percutaneous Endoscopic Lumbar Discectomy for Far-Migrated Disc Herniation.
abstract: Objective.To describe the two-level percutaneous endoscopic lumbar discectomy (PELD) technique in transforaminal approach for highly migrated disc herniation and investigate its clinical outcomes.Methods.A total of 22 consecutive patients with highly migrated lumbar disc herniation were enrolled for the study from June 2012 to February 2014.Results.There were 12 males and 10 females, with a mean age of 41.1 (range 23-67) years. The mean follow-up period was 18.05 (range 14-33) months. According to the modified MacNab criteria, the clinical outcome at the final follow-up was excellent in 14, good in 6, and fair in 2 patients and the satisfactory rate (excellent and good) was 90.9%. The improvements in VAS and ODI were statistically significant. One patient had recurrent herniation in 18 months after the first surgery and underwent open discectomy. One patient showed symptoms of postoperative dysesthesia (POD), but the POD symptom was transient and partial remission was achieved in two months after conservative treatment.Conclusion.Two-level PELD in transforaminal approach can be a safe and effective procedure for highly migrated disc herniation.
authors.affiliation: Department of Orthopedic, Tenth People's Hospital, Tongji University, Shanghai 200072, China; Department of Orthopedic, Tongji Hospital, Tongji University, Shanghai 200072, China.
authors.forename: Xinbo
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Orthopedic, Tenth People's Hospital, Tongji University, Shanghai 200072, China.
authors.forename: Guoxin
authors.initials: G
authors.lastname: Fan
authors.affiliation: Department of Orthopedic, Tenth People's Hospital, Tongji University, Shanghai 200072, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Gu
authors.affiliation: Department of Orthopedic, Tenth People's Hospital, Tongji University, Shanghai 200072, China.
authors.forename: Xiaofei
authors.identifier: 0000-0002-9088-2486
authors.initials: X
authors.lastname: Guan
authors.affiliation: Department of Orthopedic, Tenth People's Hospital, Tongji University, Shanghai 200072, China.
authors.forename: Shisheng
authors.identifier: 0000-0002-5040-886X
authors.initials: S
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D017587:Diskectomy, Percutaneous / Q000379:methods*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D000070614:Nucleus Pulposus / Q000473:pathology; D061646:Operative Time; D010147:Pain Measurement; D011183:Postoperative Complications; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult