Gerald Musa, Medetbek D Abakirov, Naya Arzoumi, Samat T Mamyrbaev, Rossi E Barrientos Castillo, Gennady E Chmutin, Jeff Ntalaja, Tshiunza Mpoyi Chérubin, Edinson David Berrio Perea, Gervit Reyes-Soto, Carlos Castillo-Rangel, Manuel De Jesus Encarnacion Ramirez, Nicola Montemurro
{"title":"椎间孔内窥镜椎间盘切除术是治疗复发性腰椎间盘突出症的最佳选择吗？系统评价。","authors":"Gerald Musa, Medetbek D Abakirov, Naya Arzoumi, Samat T Mamyrbaev, Rossi E Barrientos Castillo, Gennady E Chmutin, Jeff Ntalaja, Tshiunza Mpoyi Chérubin, Edinson David Berrio Perea, Gervit Reyes-Soto, Carlos Castillo-Rangel, Manuel De Jesus Encarnacion Ramirez, Nicola Montemurro","doi":"10.14444/8698","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent lumbar disc herniation (rLDH) remains a challenge in spinal surgery. This systematic review analyzes the use of transforaminal endoscopic discectomy (TFED) for the treatment of rLDH.</p><p><strong>Methods: </strong>A comprehensive search of 4 electronic databases, including PubMed, Google Scholar, Science Direct, and Cochrane, was conducted. Studies that analyzed the use of TFED to manage rLDH were included in the review. The primary outcomes assessed in these studies encompassed postoperative complications, length of surgery, blood loss, duration of hospitalization, pain scores, and recurrence rates.</p><p><strong>Results: </strong>Six studies met the inclusion criteria, comprising 405 patients. The mean duration of surgery was 24 to 158.74 minutes with intraoperative estimated blood loss of 0 to 34.8 mL. The mean recurrence rate was 4.4% with a 0.7% progression to fusion during the follow-up period. Durotomy was seen in 2.7% of cases. There was a 0.1% incidence of temporary nerve irritation with no permanent nerve injuries reported.</p><p><strong>Conclusions: </strong>TFED for the management of rLDH is a lateral minimally invasive technique that avoids going through scar tissue, hence associated with a short duration of surgery, minimal to no measurable blood loss, and a very low complication rate. The few studies in the literature seem to suggest that TFED should be considered in patients with rLDH without segmental instability who meet the criteria for surgery.</p><p><strong>Level of evidence: 5: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":"19 1","pages":"49-56"},"PeriodicalIF":1.7000,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053245/pdf/","citationCount":"0","resultStr":"{\"title\":\"Is Transforaminal Endoscopic Discectomy the Best Option for Recurrent Lumbar Disc Herniation? A Systematic Review.\",\"authors\":\"Gerald Musa, Medetbek D Abakirov, Naya Arzoumi, Samat T Mamyrbaev, Rossi E Barrientos Castillo, Gennady E Chmutin, Jeff Ntalaja, Tshiunza Mpoyi Chérubin, Edinson David Berrio Perea, Gervit Reyes-Soto, Carlos Castillo-Rangel, Manuel De Jesus Encarnacion Ramirez, Nicola Montemurro\",\"doi\":\"10.14444/8698\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Recurrent lumbar disc herniation (rLDH) remains a challenge in spinal surgery. This systematic review analyzes the use of transforaminal endoscopic discectomy (TFED) for the treatment of rLDH.</p><p><strong>Methods: </strong>A comprehensive search of 4 electronic databases, including PubMed, Google Scholar, Science Direct, and Cochrane, was conducted. Studies that analyzed the use of TFED to manage rLDH were included in the review. The primary outcomes assessed in these studies encompassed postoperative complications, length of surgery, blood loss, duration of hospitalization, pain scores, and recurrence rates.</p><p><strong>Results: </strong>Six studies met the inclusion criteria, comprising 405 patients. The mean duration of surgery was 24 to 158.74 minutes with intraoperative estimated blood loss of 0 to 34.8 mL. The mean recurrence rate was 4.4% with a 0.7% progression to fusion during the follow-up period. Durotomy was seen in 2.7% of cases. There was a 0.1% incidence of temporary nerve irritation with no permanent nerve injuries reported.</p><p><strong>Conclusions: </strong>TFED for the management of rLDH is a lateral minimally invasive technique that avoids going through scar tissue, hence associated with a short duration of surgery, minimal to no measurable blood loss, and a very low complication rate. The few studies in the literature seem to suggest that TFED should be considered in patients with rLDH without segmental instability who meet the criteria for surgery.</p><p><strong>Level of evidence: 5: </strong></p>\",\"PeriodicalId\":38486,\"journal\":{\"name\":\"International Journal of Spine Surgery\",\"volume\":\"19 1\",\"pages\":\"49-56\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-03-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053245/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Spine Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14444/8698\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Spine Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14444/8698","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Is Transforaminal Endoscopic Discectomy the Best Option for Recurrent Lumbar Disc Herniation? A Systematic Review.
Introduction: Recurrent lumbar disc herniation (rLDH) remains a challenge in spinal surgery. This systematic review analyzes the use of transforaminal endoscopic discectomy (TFED) for the treatment of rLDH.
Methods: A comprehensive search of 4 electronic databases, including PubMed, Google Scholar, Science Direct, and Cochrane, was conducted. Studies that analyzed the use of TFED to manage rLDH were included in the review. The primary outcomes assessed in these studies encompassed postoperative complications, length of surgery, blood loss, duration of hospitalization, pain scores, and recurrence rates.
Results: Six studies met the inclusion criteria, comprising 405 patients. The mean duration of surgery was 24 to 158.74 minutes with intraoperative estimated blood loss of 0 to 34.8 mL. The mean recurrence rate was 4.4% with a 0.7% progression to fusion during the follow-up period. Durotomy was seen in 2.7% of cases. There was a 0.1% incidence of temporary nerve irritation with no permanent nerve injuries reported.
Conclusions: TFED for the management of rLDH is a lateral minimally invasive technique that avoids going through scar tissue, hence associated with a short duration of surgery, minimal to no measurable blood loss, and a very low complication rate. The few studies in the literature seem to suggest that TFED should be considered in patients with rLDH without segmental instability who meet the criteria for surgery.
期刊介绍：
The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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