Clinical Outcome of Minimally Invasive Decompression Without Discectomy in Contained Foraminal Disc Herniation: A Single-Center Study

doi:10.1016/j.wneu.2018.06.192

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Title:	Clinical Outcome of Minimally Invasive Decompression Without Discectomy in Contained Foraminal Disc Herniation: A Single-Center Study
Authors:	Wong, Kin Weng Ho, Chung-Han Yu, Tzai-Chiu Wu, Chung-Da Tsang, Yi-Sheng
Contributors:	Chi Mei Med Ctr, Dept Orthoped Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Hualien Tzu Chi Hosp, Buddhist Tzu Chi Med Fdn, Dept Orthoped Cheok Spine Hosp, Dept Neurosurg
Keywords:	Discectomy Foraminal disc herniation Foraminal stenosis Minimally invasive spine surgery Paraspinal approach Wiltse approach
Date:	2018-10
Issue Date:	2019-11-15 15:45:05 (UTC+8)
Publisher:	ELSEVIER SCIENCE INC
Abstract:	BACKGROUND: Foraminal disc herniation is rare. When conservative treatment fails, it is often treated with discectomy via a paraspinal or Wiltse approach. In contained foraminal disc herniation, more symptoms arise from the foraminal compression of the exiting nerve root, including the dorsal root ganglion, than from the herniation itself. We aimed to evaluate the benefits of stand-alone decompression without discectomy for patients with contained foraminal disc herniation. METHODS: This study included 17 patients with unilateral single-level foraminal disc herniation (14 women and 3 men; mean age, 62.8 +/- 14.6 years, range, 37-86 years). Disc herniation was confirmed as contained by preoperative magnetic resonance imaging and/or computed tomography and by intraoperative exploration. All patients underwent thorough decompression without discectomy, via a paraspinal approach. Pain was evaluated preoperatively and at 3 and 12 months postoperatively using a visual analog scale (VAS). The Oswestry Disability Index (ODI) and Macnab criteria were used to evaluate final outcomes. RESULTS: The most commonly affected level was L5-S1. All 17 patients showed significant improvements in VAS and ODI scores at 3 and 12 months postoperatively. According to the Macnab criteria, outcome results were excellent in 13 patients and good in 4. The mean duration of follow-up was 18.4 +/- 2.4 months, with no recurrences or lumbar instability at the final follow-up. CONCLUSIONS: Stand-alone decompression without discectomy is an effective method for relieving symptoms and preserving the disc in contained foraminal disc herniation. A minimally invasive approach with thorough decompression techniques yields good results.
???metadata.dc.relation.uri???:	http://dx.doi.org/10.1016/j.wneu.2018.06.192
Relation:	Materials Chemistry and Physics, v.118, pp,E367-E374
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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