Feasibility and efficacy of percutaneous lateral lumbar discectomy in the treatment of patients with lumbar disc herniation: a preliminary experience

Wenjin Jiang, Bolin Sun, Qirui Sheng, Xuepeng Song, Yanbo Zheng, Ligang Wang, Wenjin Jiang, Bolin Sun, Qirui Sheng, Xuepeng Song, Yanbo Zheng, Ligang Wang

Abstract

Objective: This study was aimed at evaluating the effectiveness and safety of percutaneous lateral lumbar discectomy (PLLD) in treating patients with lumber disc herniation.

Methods: A total of 183 patients with lumbar disc herniation were recruited to receive PLLD surgery from April 2006 to October 2011. All the adverse effects were recorded during the follow-up at 1, 3, 6, and 12 months after PLLD. The clinical outcomes were determined by visual analog scale and Japanese Orthopaedic Association SCORE.

Results: The surgery was performed successfully in all patients (102 males and 81 females aged from 21 to 66 years) with a mean 16.6-month follow-up (range from 26 to 65 months). No postoperative complications, including intestinal and vascular complications, nerve injuries, and postoperative infections, were associated with PLLD. At one month after surgery, visual analog scale (3.12 ± 1.44 versus 6.76 ± 2.31, P<0.05) was significantly lower than the baseline and was sustained until 24 months after surgery (3.25 ± 1.78 versus 6.76 ± 2.31, P<0.05). Besides that, Japanese Orthopaedic Association score (25.25 ± 3.21 versus 11.78 ± 2.38, P<0.05) was increased when compared to the baseline.

Conclusions: PLLD was a promising, mini-invasive, and effective treatment for lumber disc herniation.

Figures

Figure 1
Figure 1
Surgical technique and procedures of PLLD surgery: (a) surgical instruments used for PLLD surgery; (b) the markers for indicating the skin entry site; (c) needle insertion was performed at the selected skin entry site; (d) the view of the relative position between the intestines and the intervertebral space under fluoroscopy.
Figure 2
Figure 2
A representative nucleus pulposus removed by PLLD surgery with the length longer than 4 cm.
Figure 3
Figure 3
(a) Pre- and (b) postoperative CT images of a representative patient with L4-5 intervertebral disc herniation (the protrusion is indicated by white arrows); protrusion was reduced significantly 1 week after the operation (as indicated by white arrows).

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