Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation
Introduction. “U” route transforaminal percutaneous endoscopic lumbar discectomy (PELD) was introduced for lumbar spinal stenosis (LSS) combined with disc herniation (DH) treatment. This study aims to explore the efficacy and safety of “U” route PELD on chronic pain patients with LSS combined with D...
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doaj-dd7dc5de451e4eb49a9d5a2814b254c52021-02-15T12:52:49ZengHindawi LimitedPain Research and Management1203-67651918-15232021-01-01202110.1155/2021/66574636657463Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc HerniationBinbin Wu0Xinyi Tian1Ce Shi2Chenchen Jiang3Jing Zhang4Gonghao Zhan5Danli Xie6Department of Pain Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Pain Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Orthopedics, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, ChinaDepartment of Clinical Research Center, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, ChinaChina-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Pain Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, ChinaDepartment of Microbiology and Immunology, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou 325035, Zhejiang, ChinaIntroduction. “U” route transforaminal percutaneous endoscopic lumbar discectomy (PELD) was introduced for lumbar spinal stenosis (LSS) combined with disc herniation (DH) treatment. This study aims to explore the efficacy and safety of “U” route PELD on chronic pain patients with LSS combined with DH. Methods. Degenerative LSS combined with DH patients who underwent “U” route PELD were reexamined, and 80 patients were recruited and followed up for 2 years. The other 80 healthy individuals who were age- and sex-matched to the patients without chronic pain were enrolled as healthy controls. Minimum dura sac cross-sectional area (mDCSA) by MRI, Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab outcomes were assessed. Emotional evaluation of pain catastrophizing and depression was documented with Pain Catastrophizing Scale (PCS) and Beck Depression Inventory (BDI), respectively, for patients before and after surgery and healthy individuals. Results . All patients were of the age range from 47 to 85 years, with an average of 59.5 ± 9.76 years. Symptoms duration was 114.6 ± 22.77 months, operation time was 87.7 ± 25.20 minutes, and the average hospital stay was 5.8 ± 2.81 days. Four patients quit, and hence, a total of 76 patients completed the follow-up. The results indicated that mDCSA was improved significantly after operation (p<0.001), either low back and leg VAS or ODI decreased over time (p<0.001), and the excellent-to-good rate was improved from 88.75% to 93.42% during postoperative 2 years (p<0.05). Complications of dural tear, nerve root, or dysesthesia were reported in 5 patients, and all recovered after conservative therapy. The scores of pain catastrophizing were reduced after operation (p<0.001), but no significance of BDI was found between patients and healthy controls (p>0.05). Conclusions. The “U” route PELD seems an alternative to LSS combined with DH treatment, which might reach a better decompression and effectively improve chronic pain conditions. Still, the complications were potential and required further consideration.http://dx.doi.org/10.1155/2021/6657463 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Binbin Wu Xinyi Tian Ce Shi Chenchen Jiang Jing Zhang Gonghao Zhan Danli Xie |
spellingShingle |
Binbin Wu Xinyi Tian Ce Shi Chenchen Jiang Jing Zhang Gonghao Zhan Danli Xie Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation Pain Research and Management |
author_facet |
Binbin Wu Xinyi Tian Ce Shi Chenchen Jiang Jing Zhang Gonghao Zhan Danli Xie |
author_sort |
Binbin Wu |
title |
Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation |
title_short |
Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation |
title_full |
Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation |
title_fullStr |
Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation |
title_full_unstemmed |
Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation |
title_sort |
clinical outcomes of “u” route transforaminal percutaneous endoscopic lumbar discectomy in chronic pain patients with lumbar spinal stenosis combined with disc herniation |
publisher |
Hindawi Limited |
series |
Pain Research and Management |
issn |
1203-6765 1918-1523 |
publishDate |
2021-01-01 |
description |
Introduction. “U” route transforaminal percutaneous endoscopic lumbar discectomy (PELD) was introduced for lumbar spinal stenosis (LSS) combined with disc herniation (DH) treatment. This study aims to explore the efficacy and safety of “U” route PELD on chronic pain patients with LSS combined with DH. Methods. Degenerative LSS combined with DH patients who underwent “U” route PELD were reexamined, and 80 patients were recruited and followed up for 2 years. The other 80 healthy individuals who were age- and sex-matched to the patients without chronic pain were enrolled as healthy controls. Minimum dura sac cross-sectional area (mDCSA) by MRI, Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab outcomes were assessed. Emotional evaluation of pain catastrophizing and depression was documented with Pain Catastrophizing Scale (PCS) and Beck Depression Inventory (BDI), respectively, for patients before and after surgery and healthy individuals. Results . All patients were of the age range from 47 to 85 years, with an average of 59.5 ± 9.76 years. Symptoms duration was 114.6 ± 22.77 months, operation time was 87.7 ± 25.20 minutes, and the average hospital stay was 5.8 ± 2.81 days. Four patients quit, and hence, a total of 76 patients completed the follow-up. The results indicated that mDCSA was improved significantly after operation (p<0.001), either low back and leg VAS or ODI decreased over time (p<0.001), and the excellent-to-good rate was improved from 88.75% to 93.42% during postoperative 2 years (p<0.05). Complications of dural tear, nerve root, or dysesthesia were reported in 5 patients, and all recovered after conservative therapy. The scores of pain catastrophizing were reduced after operation (p<0.001), but no significance of BDI was found between patients and healthy controls (p>0.05). Conclusions. The “U” route PELD seems an alternative to LSS combined with DH treatment, which might reach a better decompression and effectively improve chronic pain conditions. Still, the complications were potential and required further consideration. |
url |
http://dx.doi.org/10.1155/2021/6657463 |
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