International Journal of Frontiers in Medicine, 2024, 6(2); doi: 10.25236/IJFM.2024.060203.
Yuhao Gao1,4, Fangzheng He1,3, Hualv Liu1,4, Songfeng Li1,3, Shilei Qin2,4, Pengfei Han3, Yunfeng Xu2,4
1Department of Graduate School, Graduate Student Department of Changzhi Medical College, Changzhi, Shanxi, 046000, China
2Department of Orthopaedics, Changzhi Yunfeng Hospital, Changzhi, Shanxi, 046000, China
3Department of Orthopaedics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, 046000, China
4Changzhi Institute of Spinal Disease, Changzhi, Shanxi, 046000, China
Lumbar disc herniation (LDH) is a prevalent degenerative lumbar disease in spine surgery, characterized by pain and discomfort in the lower back and lower limbs, accompanied by limited mobility. This not only significantly impacts patients' quality of life but also imposes a substantial economic burden on both society and individuals. The clinical management of lumbar disc herniation includes non-surgical and surgical approaches. Surgical intervention is typically necessary when conservative treatment proves ineffective or in cases of progressive and substantial weakness in the lower limbs or cauda equina syndrome. In recent years, minimally invasive surgery has gained prominence in the field of spine surgery in China and has become one of the leading surgical methods for treating LDH. Percutaneous Endoscopic Lumbar Discectomy (PELD) has demonstrated remarkable clinical efficacy in LDH treatment, although some patients still experience complications after the operation, particularly postoperative recurrence. In this article, we present a case of recurrent LDH following PELD and its subsequent treatment with open surgical revision. Additionally, we discuss the risk factors associated with postoperative recurrence of LDH to provide insights for clinical practice.
Lumbar disc herniation, Transforaminal endoscopic discectomy, Minimally invasive surgery, Lumbar vertebrae, Renovation
Yuhao Gao, Fangzheng He, Hualv Liu, Songfeng Li, Shilei Qin, Pengfei Han, Yunfeng Xu. Open revision after minimally invasive lumbar transforaminal endoscopic surgery: A case report and literature review. International Journal of Frontiers in Medicine (2024), Vol. 6, Issue 2: 16-22. https://doi.org/10.25236/IJFM.2024.060203.
[1] CHO S, LIM Y C, KIM E J.Analysis of Conservative Treatment Trends for Lumbar Disc Herniation with Radiculopathy in Korea: A Population-Based Cross-Sectional Study[J/OL]. HEALTHCARE, 2023, 11(16): 2353. DOI:10.3390/healthcare11162353.
[2] N V, O S. Physical signs in lumbar disc hernia[J/OL]. Clinical orthopaedics and related research, 1996(333)[2024-01-06]. https://pubmed.0009.myie.top/8981896/.
[3] WW Y, J K. Herniated discs: when is surgery necessary?[J/OL]. EFORT open reviews, 2021, 6(6)[2024-01-06]. https://pubmed.0009.myie.top/34267943/. DOI:10.1302/2058-5241.6.210020.
[4] M P, Q L, S L. Percutaneous Endoscopic Lumbar Discectomy: Indications and Complications [J/OL]. Pain physician, 2020, 23(1)[2024-01-06]. https://pubmed.0009. myie.top/32013278/.
[5] L T, S B, G M. Transforaminal percutaneous endoscopic lumbar discectomy: outcome and complications in 270 cases[J/OL]. Journal of neurosurgical sciences, 2020, 64(6)[2024-01-06]. https://pubmed. 0009.myie.top/29582973/. DOI:10.23736/S0390-5616.18.04395-3.
[6] YANG J, LIU R, MIAO Y. Risk Factors for Recurrence After Percutaneous Endoscopic Lumbar Discectomy: A Meta-Analysis[J/OL]. World Neurosurgery, 2023, 172: 88-93. DOI:10.1016/j.wneu. 2023.02. 009.
[7] SHEPARD N, CHO W. Recurrent Lumbar Disc Herniation: A Review[J/OL]. Global Spine Journal, 2019, 9(2): 202-209. DOI:10.1177/2192568217745063.
[8] WERA G D, MARCUS R E, GHANAYEM A J. Failure within one year following subtotal lumbar discectomy [J/OL]. The Journal of Bone and Joint Surgery. American Volume, 2008, 90(1): 10-15. DOI:10.2106/JBJS.F.01569.
[9] SHIN B J. Risk factors for recurrent lumbar disc herniations[J/OL]. Asian Spine Journal, 2014, 8(2): 211-215. DOI:10.4184/asj.2014.8.2.211.
[10] LI H, DENG W, WEI F. Factors related to the postoperative recurrence of lumbar disc herniation treated by percutaneous transforaminal endoscopy: A meta-analysis[J/OL]. Frontiers in Surgery, 2023, 9: 1049779. DOI:10.3389/fsurg.2022.1049779.
[11] WANG L, ZHOU C, LIU X. Study on Influencing Factors of Postoperative Recurrence of Lumbar Disc Herniation Treated by Percutaneous Transforaminal Endoscopic Discectomy[J/OL]. Indian Journal of Pharmaceutical Sciences, 2021, 0(0): 198-204. DOI:10.36468/pharmaceutical-sciences. spl.394.
[12] MCGIRT M J, AMBROSSI G L G, DATOO G. Recurrent disc herniation and long-term back pain after primary lumbar discectomy: review of outcomes reported for limited versus aggressive disc removal [J/OL]. Neurosurgery, 2009, 64(2): 338-344; discussion 344-345. DOI:10.1227/01.NEU. 0000337574.58662.E2.
[13] MILLER L E, ALLEN R T, DUHON B. Expert review with meta-analysis of randomized and nonrandomized controlled studies of Barricaid annular closure in patients at high risk for lumbar disc reherniation [J/OL]. Expert Review of Medical Devices, 2020, 17(5): 461-469. DOI:10.1080/ 17434440. 2020.1745061.
[14] MILLER L E, MCGIRT M J, GARFIN S R. Association of Annular Defect Width After Lumbar Discectomy With Risk of Symptom Recurrence and Reoperation: Systematic Review and Meta-analysis of Comparative Studies[J/OL]. Spine, 2018, 43(5): E308. DOI:10.1097/BRS.0000000000002501.
[15] AHN Y, LEE S, SON S. Learning Curve for Transforaminal Percutaneous Endoscopic Lumbar Discectomy: A Systematic Review[J/OL]. World Neurosurgery, 2020, 143: 471-479. DOI:10.1016/j. wneu. 2020.08.044.
[16] AHN S S, KIM S H, KIM D W. Learning Curve of Percutaneous Endoscopic Lumbar Discectomy Based on the Period (Early vs. Late) and Technique (in-and-out vs. in-and-out-and-in): A Retrospective Comparative Study[J/OL]. Journal of Korean Neurosurgical Society, 2015, 58(6): 539-546. DOI:10.3340/jkns.2015.58.6.539.
[17] HSU H T, CHANG S J, YANG S S. Learning curve of full-endoscopic lumbar discectomy[J/OL]. European Spine Journal, 2013, 22(4): 727-733. DOI:10.1007/s00586-012-2540-4.
[18] KONG M, XU D, GAO C. Risk Factors for Recurrent L4-5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy: A Retrospective Analysis of 654 Cases[J/OL]. Risk Management and Healthcare Policy, 2020, 13: 3051. DOI:10.2147/RMHP.S287976.
[19] WANG F, CHEN K, LIN Q. Earlier or heavier spinal loading is more likely to lead to recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy[J/OL]. JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, 2022, 17(1): 356. DOI:10.1186/s13018-022-03242-x.
[20] EJ C, MY H, B Y. Activity restrictions after posterior lumbar discectomy. A prospective study of outcomes in 152 cases with no postoperative restrictions[J/OL]. Spine, 1999, 24(22)[2024-01-09]. https://pubmed.ncbi.nlm.nih.gov/10586459/. DOI:10.1097/00007632-199911150-00010.+