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Targeted fully endoscopic visualized laminar trepanning approach under local anaesthesia for resection of highly migrated lumbar disc herniation

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A Correction to this article was published on 07 May 2022

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Abstract

Purpose

To introduce a new fully endoscopic visualized laminar trepanning approach with a periendoscopic trephine under local anesthesia for resection of highly migrated lumbar disc herniation (LDH) and report the clinical outcomes of one year follow-up.

Methods

Twenty-one patients with highly migrated LDH who underwent percutaneous endoscopic lumbar discectomy via the laminar trepanning approach from June 2019 to August 2020 were retrospectively reviewed. Patient-Reported Outcomes Measurement Information System (PROMIS) Short Forms-Pain Interference (PI) and Physical Function (PF) were selected as outcome measures. The operating duration and complication were documented.

Results

The average age of the 21 patients (15 males, 6 females) was 37.8 ± 6.0 years (29–52 years). Disc migration originated from L4/5 in 19 patients, L5/S1 in two patients. The mean operative duration was 54.1 ± 9.0 minutes (42–79 min). All patients were followed up to 12 months after the operation. PROMIS PI T-scores decreased significantly from pre-operatively mean 68.6 ± 2.4 to 54.4 ± 1.9 (P < 0.001) and 47.1 ± 4.3 (P < 0.001) at six weeks and 12 months, respectively. PROMIS PF T-scores improved significantly from pre-operatively mean 26.7 ± 4.7 to 44.3 ± 4.2(P < 0.001) and 58.4 ± 4.0 (P < 0.001) at six weeks and 12 months, respectively. No complications and disc herniation recurrences occurred.

Conclusion

The targeted full endoscopic laminar trepanning under local anesthesia with a visualized periendoscopic trephine offers a safe, efficient and cost-effective option for the resection of highly migrated LDH.

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Data availability

The authors affirm that human research participants gave informed consent for the availability of data and materials.

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Funding

This study was supported by National Key R&D Program of China (2020YFC1107402), National Natural Science Foundation of China (81871782), Tianjin Science Fund for Distinguished Young Scholars (18JCJQJC47900), Medical Innovation Fund for Clinical Application of National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation (2021-NCRC-CXJJ-ZH-22).

Author information

Author notes

  1. Chao Chen and Xun Sun contributed equally as the first co-authors.

Authors and Affiliations

  1. Clinical School/College of Orthopedics, Tianjin Medical University, No. 406 Jiefangnan Road, Hexi District, Tianjin, 300211, China

    Chao Chen, Xun Sun & Jie Liu

  2. Department of Spine Surgery, Tianjin Hospital, Tianjin University, No. 406 Jiefangnan Road, Hexi District, Tianjin, 300211, China

    Chao Chen, Xun Sun, Xinlong Ma, Dong Zhao, Haiyun Yang, Gang Liu, Baoshan Xu & Qiang Yang

  3. Department of Orthopedics, Chinese PLA General Hospital, Haidian District, No. 28 Fuxing Road, Beijing, 100853, China

    Zheng Wang

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  1. Chao Chen
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection was performed by Chao Chen, Jie Liu, Dong Zhao, Haiyun Yang and Gang Liu. Data analysis was performed by Xun Sun. The first draft of the manuscript was written by Chao Chen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Zheng Wang or Qiang Yang.

Ethics declarations

Ethics Approval

The study was approved by the Ethics committee of Tianjin Hospital (2022-028).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figures 2, 3, 4, 5.

Conflict of Interests

The authors have no relevant financial or non-financial interests to disclose.

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The original version of this article was revised. Missing this statement "Chao Chen and Xun Sun contributed equally as the first co-authors."

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Chen, C., Sun, X., Liu, J. et al. Targeted fully endoscopic visualized laminar trepanning approach under local anaesthesia for resection of highly migrated lumbar disc herniation. International Orthopaedics (SICOT) 46, 1627–1636 (2022). https://doi.org/10.1007/s00264-022-05401-5

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  • DOI: https://doi.org/10.1007/s00264-022-05401-5

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