Percutaneous endoscopic transforaminal decompression in the treatment of patients with migrated lumbar disc herniation: A retrospective study.

This is a retrospective study. We aimed to discuss the surgical strategies, safety and clinical efficacy of percutaneous endoscopic transforaminal decompression for the treatment of patients with migrated lumbar disc herniation. From May 2014 to April 2017, a total of 56 patients (32 males and 24 females) with migrated lumbar disc herniation were performed by percutaneous endoscopic decompression via transforaminal approach. All enrolled patients had clinical symptoms with radiculopathy, and were identified as single-level, soft herniated disc by computed tomography(CT) and magnetic resonance imaging(MRI). Clinical efficacy were evaluated chiefly by leg pain visual analogue scale(VAS) score, Oswestry disability index(ODI) score and modified Macnab criteria. Patients were all successfully treated by percutaneous endoscopic transforaminal decompression, with an mean operation time of 63±12 minutes. And the patients were followed up for a mean duration of 15±2.7 months(range: 12-18 months). The leg pain VAS score was dropped from 8.2±1.9 preoperatively to 2.4±1.5, 2.2±1.3 and 1.8±1.1 at 1, 6, 12 months after the operation respectively. Similarly, the ODI score was also decreased from 62.4±8.2 preoperatively to 18.4±6.2, 12.6±5.1 and 9.2±3.4 at 1, 6, 12 months postoperatively. And there were 38 excellent cases, 13 good cases and 5 fair cases by the assessment method of modified MacNab criteria at 12 months after the operation, with an excellent and good rate of 91.07%. But 2 cases were complicated with low extremity numbness, which were all recovered by conservative treatment in three weeks. No persistent neurological deficit or infection was occured in this group postoperatively. Thus, we considered that percutaneous endoscopic decompression via transforaminal approach provided a safe, effective and minimally invasive alternative for the treatment of patients with migrated lumbar disc herniation.