Transforaminal Endoscopic Discectomy for Thoracolumbar Disc Herniation: A Retrospective Study and Technical Note

Hao Chen; Zhen Zhang; Zhenyu Bian; Changju Hou; Maoqiang Li; Liulong Zhu; Xuepeng Wang

doi:10.1016/j.wneu.2023.07.013

Transforaminal Endoscopic Discectomy for Thoracolumbar Disc Herniation: A Retrospective Study and Technical Note

World Neurosurg. 2023 Oct:178:70-77. doi: 10.1016/j.wneu.2023.07.013. Epub 2023 Jul 14.

Authors

Hao Chen¹, Zhen Zhang¹, Zhenyu Bian¹, Changju Hou¹, Maoqiang Li¹, Liulong Zhu¹, Xuepeng Wang²

Affiliations

¹ Department of Orthopedic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Department of Orthopedic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China. Electronic address: wangxuepeng22@163.com.

PMID: 37454905
DOI: 10.1016/j.wneu.2023.07.013

Abstract

Background: Thoracolumbar disc herniation (TLDH) is a rare disorder with unique characteristics that can result in undesirable surgical outcomes after traditional discectomy. In view of the widespread use of transforaminal endoscopic discectomy for lower lumbar disc herniation, we investigated treatment of TLDH by this procedure. The purpose of this study was to evaluate the clinical efficacy of transforaminal endoscopic discectomy for treating TLDH and share our technical experience.

Methods: We retrospectively evaluated the clinical data of 19 patients who had undergone transforaminal endoscopic discectomy for TLDH in our institution between April 2018 and July 2021. Operation time, follow-up time, blood loss, postoperative hospital stay, visual analog scale scores for low-back and leg pain, and Japanese Orthopedic Association (JOA) scores were evaluated.

Results: The differences between preoperative and postoperative JOA and visual analog scale scores were significant (P < 0.05). According to the JOA scores, 14 of the 19 patients had excellent improvement, 3 had good improvement, and 2 had fair improvement; thus, the rate of satisfactory improvement was 89.5%.

Conclusions: Operation time, blood loss, postoperative hospital stay, and surgical outcomes were favorable. Transforaminal endoscopic discectomy is an ideal surgical procedure for treating TLDH.

Keywords: Lower thoracic disc herniation; Thoracolumbar disc herniation; Thoracolumbar junction; Transforaminal endoscopic discectomy; Upper lumbar disc herniation.