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지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Objective : Although endoscopic procedures for lumbar disc diseases have improved greatly, the postoperative outcomes for high grade inferior migrated discs are not satisfactory. Because of anatomic limitations, a rigid endoscope cannot reach all lesions effectively. The purpose of this study was to determine the feasibility of endoscopic transforaminal suprapedicular approach to high grade inferior-migrated lumbar disc herniations. Methods : Between May 2006 and March 2008, a suprapedicular approach was performed in 53 patients with high grade inferior-migrated lumbar disc herniations using a rigid endoscope and a semi-rigid flexible curved probe. One-to-four hours after surgery, the presence of remnant discs was checked with MRI. The outcomes were evaluated with the visual analogue scale (VAS) score and the Oswestry Disability Index (ODI) one week after surgery. Results : The L2-3 level was involved in 2 patients and the L3-4 level was involved in 14 patients, while the L4-5 level was involved in 39 patients. There were single piece-type in 34 cases and a multiple piece-type in 19 cases. Satisfactory results were obtained in all cases. The mean preoperative VAS for leg pain was $9.32{\pm}0.43$ points (range, 7-10 points), whereas the mean ODI was $79.82{\pm}4.53$ points (range, 68-92 points). At the last follow-up examination, the mean postoperative VAS for leg pain was $1.78{\pm}0.71$ points and the mean postoperative ODI improved to $15.27{\pm}3.82$ points. Conclusion : A high grade inferior migrated lumbar disc is difficult to remove sufficiently by posterolateral endoscopic lumbar dscectomy using a rigid endoscope. However, a satisfactory result can be obtained by applying a transforaminal suprapedicular approach with a flexible semi-rigid curved probe.
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참고문헌 (50)
참고문헌 신청
Ahn Y / 2004 / Percutaneous endoscopic lumbar discectomy for recurrent disc herniation : surgical technique, outcome, and prognostic factors of 43 consecutive cases / Spine 29:E326~E332
Andrews DW / 1990 / Retrospective analysis of microsurgical and standard lumbar discectomy / Spine 15:329~335
Asch HL / 2002 / Prospective multiple outcomes study of outpatient lumbar microdiscectomy : should 75 to 80% success rates be the norm? / J Neurosurg 96(1):34~44
BenDebba M / 1999 / Association between peridural scar and activity-related pain after lumbar discectomy / Neurol Res 21(1):S37~S42
Calisaneller T / 2007 / Six months postoperative clinical and 24 hour post-operative MRI examinations after nucleoplasty with radiofrequency energy / Acta Neurochir (Wien) 149:495~500
Andrews DW / 1990 / Retrospective analysis of microsurgical and standard lumbar discectomy / Spine 15:329~335
Asch HL / 2002 / Prospective multiple outcomes study of outpatient lumbar microdiscectomy : should 75 to 80% success rates be the norm? / J Neurosurg 96(1):34~44
BenDebba M / 1999 / Association between peridural scar and activity-related pain after lumbar discectomy / Neurol Res 21(1):S37~S42
Calisaneller T / 2007 / Six months postoperative clinical and 24 hour post-operative MRI examinations after nucleoplasty with radiofrequency energy / Acta Neurochir (Wien) 149:495~500
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