Türk Nöroşirürji Dergisi 2009 , Vol 19 , Num 3
Lumbar Transforaminal Endoscopic Discectomy
Mehdi SASANİ
Amerikan Hastanesi, Nöroşirürji Kliniği, İstanbul, Türkiye OBJECTIVE: Extraforaminal lumbar disc herniations represent up to 11% of all lumbar herniated discs.Numerous surgical approaches have been described.Transforaminal endoscopic discectomy(TED) is one of the minimal invasive surgeries after mastering this procedure, it is practical technique that is used for treatment of disc herniation

METHOD: Total of 66 patients with foraminal or extraforaminal lumbar disc herniation were treated by applying TED technique. Thirty-six patients were female and thirty patients were male and the ages of the patients were between 35-73(median 52). The patients evaluation with clinical examination, lumbar MRI, Visual Analog Pain(VAS) and Oswestry scale.

RESULTS: Proposition of herniated disc levels were on L2-3(8%), L3-4(28%) and L4-5(64%). Complication rate was 14.2% including 5 patients(7.1%) who disc material could not be removed with TED, five patients(7.1%) who root nerves were partially damaged. Oswestry and VAS scores decreased significantly in postoperative follow-ups.

CONCLUSION: TED is a minimal invasive method and offers many benefits to the patient, but surgical practice is needed to become a capable surgeon. Compare with classic discectomy method, TED is suggested as a first choose method, and compare with paravertebral microscopic discectomy is alternative procedures. Moreover, this study reconfirmed that the removal of fragmented disc material is achieved and offers pain free status. Anahtar Kelimeler : Endoscopic discectomy, Intervertebral disc herniation, Lumbar spine, Foraminal disc herniation, Extraforaminal disc herniation