scholarly journals Full Endoscopic Lumbar Discectomy Versus Laminectomy for Cauda Equina Syndrome

10.14444/8014 ◽  
2021 ◽  
Vol 15 (1) ◽  
pp. 105-112
Author(s):  
Liu Yankang ◽  
Zhang Leiming ◽  
Kai-Uwe Lewandrowski ◽  
Tang Xiangyu ◽  
Zhu Zexing ◽  
...  
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Lumbar Discectomy ◽  
Endoscopic Lumbar Discectomy

Percutaneous Endoscopic Lumbar Discectomy for Treating Cauda Equina Syndrome Due To Lumbar Disc Herniation

2021 ◽  
Author(s):  
Hai-Chao He ◽  
Xiao-qiang LV ◽  
Yong-Jin Zhang
Keyword(s):  
Back Pain ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Endoscopic Lumbar Discectomy

Abstract Background In recent decades, endoscopic techniques to treat lumbar disc herniation (LDH) have gained popularity in clinical practice. However, there is little literature on the use of percutaneous endoscopic lumbar discectomy (PELD) to treat cauda equina syndrome (CES) due to LDH. This study aims to evaluate the feasibility and clinical efficacy of PELD for treating CES caused by disc herniation, and as well as to report some technical strategies. Methods Between October 2012 and April 2018, 15 patients with CES caused by LDH at the early and intermediate stages of Shi’s classification were selected as the subjects of study, and underwent PELD. All patients were followed up for at least two years. The patients’ back pain and leg pain were evaluated using visual analogue scale (VAS) scores and the Oswestry Disability Index (ODI). Patient satisfaction was evaluated using the MacNab outcome scale. Clinical outcomes were measured preoperatively and at 3 days, 3 months, 6 months and the last follow-up. Results The VAS score for back pain, leg pain and ODI score significantly decreased from preoperatively scores of 6.67 ± 1.05, 7.13 ± 1.19 and 62.0 ± 6.85 respectively, to postoperatively cores of 1.80 ± 0.41, 1.47 ± 0.52 and 12.93 ± 1.03 at the last follow-up postoperatively. These postoperative scores were all significantly different compared with preoperative scores (P < 0.01). According to the modified MacNab outcome scale, 86.67% of these patients had excellent and good outcomes at the final follow-up. Complications included one patient with cerebrospinal fluid leakage and one patient who developed recurrent herniation; the latter patient finally achieved satisfactory results after reoperation. Conclusion PELD could be used as an alternative surgical method for the treatment of CES due to LDH in properly selected cases and appropriate patient selection. However, the operator should pay attention to foraminoplasty to enlarge the working space.

scholarly journals Percutaneous Endoscopic Lumbar Discectomy for a Huge Herniated Disc Causing Acute Cauda Equina Syndrome: A Case Report

2015 ◽  
Vol 62 (1.2) ◽  
pp. 100-102 ◽  
Author(s):  
Subash C. Jha ◽  
Ichiro Tonogai ◽  
Yoichiro Takata ◽  
Toshinori Sakai ◽  
Kosaku Higashino ◽  
...  
Keyword(s):  
Case Report ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Lumbar Discectomy ◽  
Herniated Disc ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
Endoscopic Lumbar Discectomy

scholarly journals Percutaneous Endoscopic Lumbar Discectomy as an Emergent Surgery for Cauda Equina Syndrome Caused by Lumbar Disc Herniation

2020 ◽  
Vol 3;23 (6;3) ◽  
pp. E259-E264
Author(s):  
Yuntao Wang
Keyword(s):  
Disc Herniation ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Lumbar Discectomy ◽  
Percutaneous Endoscopic Lumbar Discectomy ◽  
One Year ◽  
The One ◽  
Endoscopic Lumbar Discectomy ◽  
Emergent Surgery

Background: Cauda equina syndrome (CES) is a rare and serious syndrome that requires urgent surgery to improve neurological symptoms. CES can be caused by lumber disc herniation (LDH) and accounts for about 1% to 3% of all cases of disc herniation. Objectives: The purpose of this study was to analyze the characteristics and outcomes of the cases of patients with CES caused by LDH and treated by percutaneous endoscopic lumbar discectomy (PELD). Study Design: This study used a retrospective design. Setting: Research took place at the Jiangyin Hospital affiliated with Nanjing University of Chinese Medicine, Jiangsu, China. Methods: This was a retrospective study of patients treated for CES due to LDH with PELD as an emergent surgery at a single institutional department between January 2015 and March 2018. The following variables were analyzed: age, gender, the level of disc prolapse, time interval between diagnosis and surgery, lower extremity pain or weakness, perianal sensation, voluntary anal contraction, presence of bladder dysfunction, and the reversal of these deficits in follow-up. Results: After the emergent surgery with PELD, the lower extremity symptoms were all completely recovered or partly decreased. Only one patient had weakness with plantar flexion of the left foot at the one-year time point. The decreased perianal sensations were partly recovered after surgery, and 9 cases had complete recovery and 2 cases had partial recovery at the one-year follow-up. No patients had anal contraction and bladder problems after the one-year follow-up. Limitations: The number of cases reported here is limited, so we will expand the study by including an increased number of patients and a longer follow-up duration. Conclusion: Taken together, these observations show that PELD, used as a minimally invasive choice of emergent surgery, can provide enough decompression of disc prolapse and a satisfactory outcome for patients with CES caused by LDH. Key words: Cauda equina syndrome, lumbar disc herniation, outcomes, percutaneous endoscopic lumbar discectomy

scholarly journals Treatment of cauda equina syndrome due to lumbar disc herniation with percutaneous endoscopic lumbar discectomy

2020 ◽  
Author(s):  
Hai-Chao He ◽  
Yong-jin Zhang
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Lumbar Discectomy ◽  
Lumbar Pain ◽  
Limb Pain ◽  
Endoscopic Lumbar Discectomy

Abstract Background: Throughout the last decades, endoscopic techniques to treat lumbar disc herniation (LDH) have gained popularity in clinical practice. However, there is little literature on the treatment of Cauda Equina Syndrome (CES) due to lumbar disc herniation with percutaneous endoscopic lumbar discectomy (PELD). This study aims to evaluate the feasibility and clinical efficacy of PELD for CES caused by disc herniation.Methods: Between October 2012 and April 2017, 15 patients CES caused by LDH at the early and intermediate stages of Shi’s classification were selected as the objects of study, who underwent PELD. All patients were followed up for at least two years. The patients’ lumbar pain and limb pain were evaluated using visual analogue scale (VAS) scores. Patient's satisfaction was evaluated using the MacNab outcome scale. Clinical outcomes were measured preoperatively, at 3 days, 3 months, 6 month and the last follow-up.Results: The VAS score for lumbar pain was 6.67±1.05 preoperatively and 3.27±0.96, 2.73±0.46, 2.40±0.51, and 1.80±0.41, at 3 days, 3 months, 6 months and the last follow-up postoperatively respectively. The VAS score for limb pain was 7.13±1.19 preoperatively and 2.93±0.80, 2.60±0.51, 2.20±0.56, and 1.47±0.52, at 3 days, 3 months, 6 months and the last follow-up postoperatively respectively. These postoperative scores were all significantly different when compared with preoperative scores (P < 0.01). According to the modified MacNab outcome scale, excellent was obtained in 8 of 15 patients, good was obtained in 5 patients, and fair was obtained in 2 patients, and 86.67% of these patients had excellent and good outcomes at the final follow-up. Complications included one patient of cerebrospinal fluid leakage, and one patient developed recurrent herniation and who finally acquired satisfactory result after reoperation.Conclusion: PELD could be used as an alternative surgical method for the treatment of CES due to lumbar disc herniation in properly selected cases and appropriate patient selection. However, the operator should pay attention to foraminoplasty to enlarge the working space.

scholarly journals How to Confirm and Document Adequate Lumbar Spine Discectomy Intraoperatively?

2020 ◽  
pp. 1-2
Author(s):  
Joseph Gamal Boktor ◽  
Joseph Gamal Boktor ◽  
Miriam Nakanda Kakaire ◽  
Ashish Khurana ◽  
Devi Prakash Tokala
Keyword(s):  
Lumbar Spine ◽  
Neurological Deficit ◽  
Cauda Equina Syndrome ◽  
Low Cost ◽  
Cauda Equina ◽  
Lumbar Discectomy ◽  
Disc Prolapse ◽  
Common Procedure ◽  
Postoperative Mri ◽  
Disc Material

Lumbar discectomy is a common procedure for acute disc prolapse, especially in patients with neurological deficit [1]. The literature describes using fluoroscopy intraoperatively to avoid wrong level and side [2]. However, there is no method to confirm/document adequate discectomy apart from a postoperative MRI. The authors' technique involves taking clinical photos of the removed disc material. This technique provides accurate, low-cost documentation, and the patient can review it post-operatively. This could be of significant value in large disc prolapse and cauda equina syndrome surgery.

scholarly journals GELFOAM INDUCED CAUDA EQUINA SYNDROME: A CASE REPORT WITH REVIEW OF LITERATURE

2020 ◽  
pp. 1-3
Author(s):  
Nazim Mughal ◽  
Deepankar Mishra ◽  
Ajay Srivastava ◽  
Nikhat Naaz
Keyword(s):  
Spinal Surgery ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Neurological Complications ◽  
Lumbar Discectomy ◽  
Lower Limbs ◽  
Gelatin Sponge ◽  
Review Of Literature ◽  
Hemostatic Agents ◽  
Dural Sac

Gelatin sponge (Gelfoam) is quite often used for haemostasis during spine surgery. However due to its property of osmotic expansion after coming in contact with blood, it has the potential to cause serious complications as a result of compression of nearby vital neurological tissues. We report a case of cauda equina syndrome due to retained Gelfoam during spinal surgery. A 35 year old female patient presented with complaints of pain and numbness in lower limbs for 5 months. MRI was suggestive of disc herniation at L4/L5. Lumbar discectomy was done and gelfoam was used for haemostasis. However, patient developed post-operative neurological complications suggestive of cauda equina syndrome. MRI showed gelfoam induced compression of dural sac. Gelfoam removal was done after which marked improvement in symptoms was observed. Conclusion: Hemostatic agents like Gelfoam which are often used during surgeries have the potential to cause compression of vital structures. Therefore, these should be removed once haemostatic control is accomplished and if it is to be retained, prompt post operatively monitoring is essential.

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