Efficacy of Percutaneous Endoscopic Transforaminal Lumbar Discectomy for unilateral sciatica due to single level disc herniation

Dr. Pramod Vasant Lokhande; Dr. Ganesh Tanaji Mundhe; Dr. Vijay Vasant Nemade; Dr. Vaibhav Bhaskar Pawar

Volume : VIII, Issue : III, March - 2018

Efficacy of Percutaneous Endoscopic Transforaminal Lumbar Discectomy for unilateral sciatica due to single level disc herniation

Dr. Pramod Vasant Lokhande, Dr. Ganesh Tanaji Mundhe, Dr. Vijay Vasant Nemade, Dr. Vaibhav Bhaskar Pawar

Abstract :

Background: Open Microlumbar Discectomy is presently the gold standard modality of treatment for lumbar interverteal disc herniation not responding to conservative modalities of treatment. Even though it is less invasive than open surgery and done through a small incision, it has inherent surgical disadvantages like muscle and ligament stripping, prolonged muscle retraction, bone resection of the lamina, facetal resection, and nerve root and dural tube retraction with a potential to cause spinal instability and scarring around the sensitive nerve roots even in a technically perfect dissection. In recent few years Percutaneous Endoscopic Lumbar Discectomy (PELD) through the Transforaminal approach to access the herniated part of the disc has gained popularity. This modality of treatment is minimally invasive and offers several advantages over open surgical methods. Aim of this study is to evaluate the efficacy of Endoscopic Discectomy in Young Adults presenting with single level lumbar disc herniation.

Methods: In this prospective study Patients of Age between 30 to 45 Years presenting with unilateral leg pain with or without low back pain who are not responding to conservative modality of treatment and those who on Magnetic Resonance Imaging (MRI) had single level soft disc herniation were invited to participate in the study. We have excluded patients with multiple level disc prolapse, disc prolapse with spondylolisthesis/lysis, disc prolapse with canal stenosis, patients with bilateral lower leg pains. With this criteria 68 patients were enrolled for this prospective study conducted between August 2013 to June 2015. In all cases Percutaneous Endoscopic Lumbar Discectomy was performed through Transforaminal approach.

Results: All patients were followed up till 1 Year post operatively. 7 patients lost follow up. Therefore data of 61 patients was analysed for evaluation of treatment. 58 patients relieved completely and resumed their job 3 months post operatively. 3 patients had recurrence with pain of lesser intensity and all these 3 patients responded to conservative therapy.

Conclusion: Our study results demonstrated good to excellent results in Carefully selected Young Adult patients with single level disc herniation in Lumbar spine. It is a safe and effective technique to early recovery with almost negligible complications.