Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience

Mohammed Helmy; Mohamed Nossier; Ahmed Hassan Abou-Zeid; Mahmoud Massoud; Ahmed Maamoun Ashour

doi:doi:10.11648/j.ijn.20220602.23

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Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience

Mohammed Helmy, Mohamed Nossier, Ahmed Hassan Abou-Zeid, Mahmoud Massoud, Ahmed Maamoun Ashour

Published in International Journal of Neurosurgery (Volume 6, Issue 2)

Received: 2 November 2022 Accepted: 16 November 2022 Published: 29 November 2022

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Abstract

With recent advances in minimally invasive surgery, full endoscopic discectomy has been more involved, not only the interlaminar approach but also the transforaminal. Transforaminal endoscopic surgery (TFES) can decompress the nerve root with less insult to surrounding soft tissues compared to interlaminar or open approaches, resulting in less postoperative pain, reduced length of stay, and early return to work. We reviewed retrospectively the clinical presentation of 20 patients with symptomatic L5-S1 disc prolapse with unilateral radicular pain whom underwent Transforaminal endoscopic surgery (TFES). Clinical and satisfactory outcomes were assessed using the visual pain analogue scale (VAS), Oswestry disability index (ODI) at follow up period 6 months postoperative. This study included 20 patients 14 males (70%) and 6 females (30%) Male to female ratio was 2.3: 1 with a mean age of 42.38 years ± 13.1 (range 25- 58 years). The preoperative mean VAS scores for radicular pain significantly decreased from 8.1± 14 to 2.8± 1.1 at 6 months follow-up (p = 0.0034). There was significant difference in VAS scores for back pain (5.7± 2.1) preoperatively to 1.9± 2 (p=0.02). ODI decreased from 57±2.5 to 11±10.5. Average length of stay was 1-3 days (1±0.5). TFES can be done for herniated L5-S1 discs bypassing the iliac crest barrier, by using an appropriate suprailiac trajectory and tailoring the entry point based on the patient’s body mass index guided by fluoroscopy.

Published in	International Journal of Neurosurgery (Volume 6, Issue 2)
DOI	10.11648/j.ijn.20220602.23
Page(s)	104-109
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Endoscope, Lumber Disc, Transforaminal, Minimally Invasive

References

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[3]	G. Choi, S.-H. Lee, P. P. Raiturker, S. Lee, and Y.-S. Chae, “Percutaneous Endoscopic Interlaminar Discectomy for Intracanalicular Disc Herniations At L5–S1 Using a Rigid Working Channel Endoscope,” Oper. Neurosurg., vol. 58, no. suppl_1, p. ONS-59-ONS-68, Feb. 2006, doi: 10.1227/01.neu.0000192713.95921.4a.
[4]	D. Y. LEE and S.-H. LEE, “Effects of Facet Tropism and Disk Degeneration on Far Lateral Lumbar Disk Herniation: Comparison With Posterolateral Lumbar Disk Herniation,” Neurol. Med. Chir. (Tokyo), vol. 49, no. 2, pp. 57–61, 2009, doi: 10.2176/nmc.49.57.
[5]	M. Komp, S. Ruetten, and G. Godolias, “P21. Full-endoscopic discectomy for lumbar disc herniations: a prospective 12-months outcome study of patients treated with new endoscopes and instruments,” Spine J., vol. 5, no. 4, p. S120, Jul. 2005, doi: 10.1016/j.spinee.2005.05.236.
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[7]	Q. Ding et al., “Percutaneous Endoscopic Lumbar Discectomy for Far Lateral L5/S1 Disc Herniation With High Iliac Crest,” Jan. 2021, doi: 10.21203/rs.3.rs-146660/v1.
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[11]	Z. Sakçı, M. R. Önen, E. Fidan, Y. Yaşar, H. Uluğ, and S. Naderi, “Radiologic Anatomy of the Lumbar Interlaminar Window and Surgical Considerations for Lumbar Interlaminar Endoscopic and Microsurgical Disc Surgery,” World Neurosurg., vol. 115, pp. e22–e26, Jul. 2018, doi: 10.1016/j.wneu.2018.03.049.
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APA Style

Mohammed Helmy, Mohamed Nossier, Ahmed Hassan Abou-Zeid, Mahmoud Massoud, Ahmed Maamoun Ashour. (2022). Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience. International Journal of Neurosurgery, 6(2), 104-109. https://doi.org/10.11648/j.ijn.20220602.23

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ACS Style

Mohammed Helmy; Mohamed Nossier; Ahmed Hassan Abou-Zeid; Mahmoud Massoud; Ahmed Maamoun Ashour. Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience. Int. J. Neurosurg. 2022, 6(2), 104-109. doi: 10.11648/j.ijn.20220602.23

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AMA Style

Mohammed Helmy, Mohamed Nossier, Ahmed Hassan Abou-Zeid, Mahmoud Massoud, Ahmed Maamoun Ashour. Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience. Int J Neurosurg. 2022;6(2):104-109. doi: 10.11648/j.ijn.20220602.23

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@article{10.11648/j.ijn.20220602.23,
  author = {Mohammed Helmy and Mohamed Nossier and Ahmed Hassan Abou-Zeid and Mahmoud Massoud and Ahmed Maamoun Ashour},
  title = {Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience},
  journal = {International Journal of Neurosurgery},
  volume = {6},
  number = {2},
  pages = {104-109},
  doi = {10.11648/j.ijn.20220602.23},
  url = {https://doi.org/10.11648/j.ijn.20220602.23},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.23},
  abstract = {With recent advances in minimally invasive surgery, full endoscopic discectomy has been more involved, not only the interlaminar approach but also the transforaminal. Transforaminal endoscopic surgery (TFES) can decompress the nerve root with less insult to surrounding soft tissues compared to interlaminar or open approaches, resulting in less postoperative pain, reduced length of stay, and early return to work. We reviewed retrospectively the clinical presentation of 20 patients with symptomatic L5-S1 disc prolapse with unilateral radicular pain whom underwent Transforaminal endoscopic surgery (TFES). Clinical and satisfactory outcomes were assessed using the visual pain analogue scale (VAS), Oswestry disability index (ODI) at follow up period 6 months postoperative. This study included 20 patients 14 males (70%) and 6 females (30%) Male to female ratio was 2.3: 1 with a mean age of 42.38 years ± 13.1 (range 25- 58 years). The preoperative mean VAS scores for radicular pain significantly decreased from 8.1± 14 to 2.8± 1.1 at 6 months follow-up (p = 0.0034). There was significant difference in VAS scores for back pain (5.7± 2.1) preoperatively to 1.9± 2 (p=0.02). ODI decreased from 57±2.5 to 11±10.5. Average length of stay was 1-3 days (1±0.5). TFES can be done for herniated L5-S1 discs bypassing the iliac crest barrier, by using an appropriate suprailiac trajectory and tailoring the entry point based on the patient’s body mass index guided by fluoroscopy.},
 year = {2022}
}

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TY  - JOUR
T1  - Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience
AU  - Mohammed Helmy
AU  - Mohamed Nossier
AU  - Ahmed Hassan Abou-Zeid
AU  - Mahmoud Massoud
AU  - Ahmed Maamoun Ashour
Y1  - 2022/11/29
PY  - 2022
N1  - https://doi.org/10.11648/j.ijn.20220602.23
DO  - 10.11648/j.ijn.20220602.23
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 104
EP  - 109
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20220602.23
AB  - With recent advances in minimally invasive surgery, full endoscopic discectomy has been more involved, not only the interlaminar approach but also the transforaminal. Transforaminal endoscopic surgery (TFES) can decompress the nerve root with less insult to surrounding soft tissues compared to interlaminar or open approaches, resulting in less postoperative pain, reduced length of stay, and early return to work. We reviewed retrospectively the clinical presentation of 20 patients with symptomatic L5-S1 disc prolapse with unilateral radicular pain whom underwent Transforaminal endoscopic surgery (TFES). Clinical and satisfactory outcomes were assessed using the visual pain analogue scale (VAS), Oswestry disability index (ODI) at follow up period 6 months postoperative. This study included 20 patients 14 males (70%) and 6 females (30%) Male to female ratio was 2.3: 1 with a mean age of 42.38 years ± 13.1 (range 25- 58 years). The preoperative mean VAS scores for radicular pain significantly decreased from 8.1± 14 to 2.8± 1.1 at 6 months follow-up (p = 0.0034). There was significant difference in VAS scores for back pain (5.7± 2.1) preoperatively to 1.9± 2 (p=0.02). ODI decreased from 57±2.5 to 11±10.5. Average length of stay was 1-3 days (1±0.5). TFES can be done for herniated L5-S1 discs bypassing the iliac crest barrier, by using an appropriate suprailiac trajectory and tailoring the entry point based on the patient’s body mass index guided by fluoroscopy.
VL  - 6
IS  - 2
ER  -

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Author Information

Mohammed Helmy

Neurosurgery department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Mohamed Nossier

Neurosurgery department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ahmed Hassan Abou-Zeid

Neurosurgery department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Mahmoud Massoud

Orthopedic & Spine Surgery, AFCM & Military Medical Academy, Cairo, Egypt
Ahmed Maamoun Ashour

Neurosurgery department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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APA Style

Mohammed Helmy, Mohamed Nossier, Ahmed Hassan Abou-Zeid, Mahmoud Massoud, Ahmed Maamoun Ashour. (2022). Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience. International Journal of Neurosurgery, 6(2), 104-109. https://doi.org/10.11648/j.ijn.20220602.23

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ACS Style

Mohammed Helmy; Mohamed Nossier; Ahmed Hassan Abou-Zeid; Mahmoud Massoud; Ahmed Maamoun Ashour. Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience. Int. J. Neurosurg. 2022, 6(2), 104-109. doi: 10.11648/j.ijn.20220602.23

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AMA Style

Mohammed Helmy, Mohamed Nossier, Ahmed Hassan Abou-Zeid, Mahmoud Massoud, Ahmed Maamoun Ashour. Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience. Int J Neurosurg. 2022;6(2):104-109. doi: 10.11648/j.ijn.20220602.23

Copy | Download

@article{10.11648/j.ijn.20220602.23,
  author = {Mohammed Helmy and Mohamed Nossier and Ahmed Hassan Abou-Zeid and Mahmoud Massoud and Ahmed Maamoun Ashour},
  title = {Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience},
  journal = {International Journal of Neurosurgery},
  volume = {6},
  number = {2},
  pages = {104-109},
  doi = {10.11648/j.ijn.20220602.23},
  url = {https://doi.org/10.11648/j.ijn.20220602.23},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.23},
  abstract = {With recent advances in minimally invasive surgery, full endoscopic discectomy has been more involved, not only the interlaminar approach but also the transforaminal. Transforaminal endoscopic surgery (TFES) can decompress the nerve root with less insult to surrounding soft tissues compared to interlaminar or open approaches, resulting in less postoperative pain, reduced length of stay, and early return to work. We reviewed retrospectively the clinical presentation of 20 patients with symptomatic L5-S1 disc prolapse with unilateral radicular pain whom underwent Transforaminal endoscopic surgery (TFES). Clinical and satisfactory outcomes were assessed using the visual pain analogue scale (VAS), Oswestry disability index (ODI) at follow up period 6 months postoperative. This study included 20 patients 14 males (70%) and 6 females (30%) Male to female ratio was 2.3: 1 with a mean age of 42.38 years ± 13.1 (range 25- 58 years). The preoperative mean VAS scores for radicular pain significantly decreased from 8.1± 14 to 2.8± 1.1 at 6 months follow-up (p = 0.0034). There was significant difference in VAS scores for back pain (5.7± 2.1) preoperatively to 1.9± 2 (p=0.02). ODI decreased from 57±2.5 to 11±10.5. Average length of stay was 1-3 days (1±0.5). TFES can be done for herniated L5-S1 discs bypassing the iliac crest barrier, by using an appropriate suprailiac trajectory and tailoring the entry point based on the patient’s body mass index guided by fluoroscopy.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Transforaminal Endoscopic L5–S1 Discectomy Case Series One Year Experience
AU  - Mohammed Helmy
AU  - Mohamed Nossier
AU  - Ahmed Hassan Abou-Zeid
AU  - Mahmoud Massoud
AU  - Ahmed Maamoun Ashour
Y1  - 2022/11/29
PY  - 2022
N1  - https://doi.org/10.11648/j.ijn.20220602.23
DO  - 10.11648/j.ijn.20220602.23
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 104
EP  - 109
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20220602.23
AB  - With recent advances in minimally invasive surgery, full endoscopic discectomy has been more involved, not only the interlaminar approach but also the transforaminal. Transforaminal endoscopic surgery (TFES) can decompress the nerve root with less insult to surrounding soft tissues compared to interlaminar or open approaches, resulting in less postoperative pain, reduced length of stay, and early return to work. We reviewed retrospectively the clinical presentation of 20 patients with symptomatic L5-S1 disc prolapse with unilateral radicular pain whom underwent Transforaminal endoscopic surgery (TFES). Clinical and satisfactory outcomes were assessed using the visual pain analogue scale (VAS), Oswestry disability index (ODI) at follow up period 6 months postoperative. This study included 20 patients 14 males (70%) and 6 females (30%) Male to female ratio was 2.3: 1 with a mean age of 42.38 years ± 13.1 (range 25- 58 years). The preoperative mean VAS scores for radicular pain significantly decreased from 8.1± 14 to 2.8± 1.1 at 6 months follow-up (p = 0.0034). There was significant difference in VAS scores for back pain (5.7± 2.1) preoperatively to 1.9± 2 (p=0.02). ODI decreased from 57±2.5 to 11±10.5. Average length of stay was 1-3 days (1±0.5). TFES can be done for herniated L5-S1 discs bypassing the iliac crest barrier, by using an appropriate suprailiac trajectory and tailoring the entry point based on the patient’s body mass index guided by fluoroscopy.
VL  - 6
IS  - 2
ER  -

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