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Clinical Outcomes of Trans-Sacral Epiduroscopic Laser Decompression (SELD) in Patients with Lumbar Disc Herniation.
Pain Research and Management ( IF 2.5 ) Pub Date : 2020-06-01 , DOI: 10.1155/2020/1537875
Seong Son 1 , Sang Gu Lee 1 , Yong Ahn 1 , Woo Kyung Kim 1
Affiliation  

Objective. Nowadays, trans-sacral epiduroscopic laser decompression (SELD) using slender epiduroscopy and laser is one of the preferred options for minimally invasive treatment in lumbar disc diseases. However, SELD is still in the initial stages of the global field of spine surgery, and the clinical outcomes in patients with lumbar disc herniation are not established yet. Therefore, the authors investigated patients undergoing SELD to report the clinical results. Methods. Between November 2015 and November 2018, a total of 82 patients who underwent single-level SELD for lumbar disc herniation with a minimum follow-up of 6.0 months were enrolled. A retrospective review of clinical data was conducted. Clinical outcomes were evaluated using the visual analogue scale (VAS) for low back and leg pain and Odom’s criteria. Also, surgical outcomes, including complications and symptom recurrences, and radiological outcomes were analyzed. Results. Low back pain and leg pain as determined by the VAS improved from an average of 5.43 ± 1.73 and 6.10 ± 1.67 to 2.80 ± 1.43 and 3.58 ± 2.08 at the final follow-up (). According to Odom’s criteria, the success rate defined as excellent or good results at the final follow-up was 58.5%. There were no surgery-related complications such as neurologic deficits, infection, or epidural hematomas, except for transient mild paralysis in 3 patients and procedure-related nuchal pain in 2 patients. The rate of additional procedures was 17.0% (6 patients received revision surgery and 8 patients received an additional nerve block) during the follow-up. Conclusion. Our findings showed that SELD for lumbar herniated disc disease achieved less favorable clinical outcomes compared with those of previous studies. Further study is needed to clarify the influencing factors on the clinical outcomes of SELD.

中文翻译:

S椎腰椎间盘突出症患者经Epi腔硬膜外激光减压术(SELD)的临床结果。

目标。如今,使用细长的硬膜外镜和激光经trans腔硬膜外激光减压术(SELD)是腰椎间盘疾病微创治疗的首选选择之一。然而,SELD仍处于全球脊柱外科领域的初期阶段,腰椎间盘突出症患者的临床结局尚未确定。因此,作者调查了接受SELD的患者以报告临床结果。方法。在2015年11月至2018年11月之间,共纳入82例接受单级SELD腰椎间盘突出症的患者,随访时间至少为6.0个月。回顾性临床数据进行。使用视觉模拟量表(VAS)对下背部和腿部疼痛以及Odom的标准评估临床结局。此外,还分析了包括并发症和症状复发在内的手术结局和影像学结局。结果。由VAS确定的下背痛和腿痛在最终随访中从平均5.43±1.73和6.10±1.67改善到2.80±1.43和3.58±2.08()。根据奥多姆(Odom)的标准,在最终随访中定义为优异或良好结果的成功率为58.5%。除了3例暂时性轻度麻痹和2例与手术相关的颈痛外,没有手术相关的并发症,如神经系统缺陷,感染或硬膜外血肿。在随访期间,额外手术的比率为17.0%(6例接受了翻修手术,8例接受了额外的神经阻滞)。结论。我们的研究结果表明,与以前的研究相比,SELD治疗腰椎间盘突出症的临床效果较差。需要进一步研究以阐明影响SELD临床结局的因素。
更新日期:2020-06-01
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