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DOI: 10.1055/s-0041-1732387
Improvement in Radicular Pain after Endoscopic Transforaminal Lumbar Discectomy at Discs with Advanced Degenerative Changes
Artikel in mehreren Sprachen: português | English![](https://www.thieme-connect.de/media/10.1055-s-00042410/202201/lookinside/thumbnails/10-1055-s-0041-1732387_2000330_en-1.jpg)
Abstract
Objectives To evaluate the correlation between radiologic changes (Pfirrmann and Modic) and radicular pain intensity in patients who underwent transforaminal endoscopic surgery for lumbar disc herniation.
Methods Series of cases with 39 patients, 50 intervertebral discs in preoperative evaluation from January 29, 2018 to August 28, 2019 in an endoscopic spine surgery service. Demographic data, surgical indication, operative details and complications were obtained from medical records. The patients were divided into three groups based on the Modic classification (Modic absence, Modic 1 and Modic 2) and into two groups considering the Pfirrmann classification (Pfirrmann IV and Pfirrmann V). Data were processed in IBM SPSS Statistics for Windows, Version 22.0 (IBM Corp., Armonk, NY, USA), with a significance level of p < 0,05.
Results There was no difference between genders; age: 50,36 ± 15,05 years old; disease level: L2–L3 1 (2%), L3–L4 2 (4%), L4–L5 9 (18%), L5–S1 8 (16%), L3–L4 + L4–L5 4 (8%), and L4–L5 + L5–S1 26 (52%); location: right foraminal 7 (14%), left foraminal 15 (30%), central 9 (18%) and diffuse 19 (38%); radicular pain: left 25 (50%), right 11 (22%), and bilateral 14 (28%); preoperative visual analogue scale (VAS): 9,5 ± 0,91, postoperative: 2,5 ± 1,79; surgery duration: 100 ± 31,36 minutes; and follow-up: 8,4 ± 6,7 months. Less postoperative sciatica was registered in the Modic 2 versus Modic 1 group (p < 0,05). There was no difference in the postoperative radicular pain between the Pfirrmann groups (IV versus V).
Conclusion Although there is no clinical difference between the groups, in advanced stages of disc degeneration, endoscopic transforaminal discectomy proved to be effective in diminishing radicular pain in patients with lumbar disc herniation.
Study developed at the Postgraduate Course in Minimally Invasive Spine Surgery of the School of Medicine of the Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Publikationsverlauf
Eingereicht: 12. September 2020
Angenommen: 11. Februar 2021
Artikel online veröffentlicht:
13. Oktober 2021
© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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