Transforaminal Endoscopic Lumbar Discectomy | DRTAMERTEKIN скачать в хорошем качестве

Transforaminal Endoscopic Lumbar Discectomy | DRTAMERTEKIN

Transforaminal Endoscopic Lumbar Discectomy performed by Dr.T.Tekin Low back and sciatic pain have been one of the most common and disabling spinal disorders recorded in medical history. Lumbar disc herniation is a major cause of back pain and sciatica. The surgical management of lumbar disc prolapse has evolved from exploratory laminectomy to percutaneous endoscopic discectomy. Mixter and Bar first published results of laminectomy and discectomy for lumbar disc prolapse. Yasargil and Caspar started the use of microscopes for posterior discectomy which limited the skin incision and lead to less muscle and epidural scarring. Patients had less postoperative pain, early rehabilitation, and early return to work. Due to these advantages, microdiscectomy became the gold standard in disc surgery. Hijikata (1975) independently experimented with mechanical nucleotomy via a 2.6-mm-od cannula that was inserted into the center of the intervertebral disc via a posterolateral access. He reported a satisfactory postoperative outcome in 64% of patients. Kambin and Schaffer (1988) used arthroscope for visualization and excision of the disc. Yeung developed rigid working channel endoscope for percutaneous endoscopic lumbar discectomy (PELD). The advantage of a percutaneous endoscopic discectomy is that the disc is approached posterolaterally through the triangle of Kambin without the need for bone or facet resection thus preserving spinal stability. There is less damage to muscular and ligamentous structures allowing for faster rehabilitation, shorter hospital stay, and earlier return to function. Although many studies have shown the efficacy of PELD with good clinical outcome, the percutaneous approach poses challenges to surgeons and the PELD, the learning curve is usually perceived to be steep. Major complications such as nerve root injury, dural tear, haematoma, visceral injury, vascular injury, and infection may occur, possibly resulting from lack of skilled surgical techniques during the learning period. The purpose of this study was to report the results of PELD by a single surgeon who had not been previously exposed to this procedure. www.drtamertekin.com