요추 추간판 탈출증에서 내시경의 추궁간 도달법을 이용한 경피적 요추 추간판 제거술의 결과 - 내시경적 후궁제거술 - (Percutaneous Endoscopic Lumbar Discectomy (PELD) Using Interlaminar Approach in Lumbar Disc Herniation - Endoscopic Laminotomy -)

서지정보

· 발행기관 : 대한척추외과학회
· 수록지 정보 : 대한척추외과학회지 / 15권 / 4호 / 250 ~ 256페이지
· 저자명 : 김응하, 류기훈, 김정관

초록

Study Design: Retrospective study
Objectives: This study examined the post-operative results of interlaminar percutaneous endoscopic lumbar discectomy (PELD)
with or without endoscopic laminotomy in lumbar disc herniation.
Summary of Literature Review: In addition to the technical feasibility, the indications of PELD surgery are usually the same as
those for open discectomy.
Materials and Methods: From January 2005 to August 2006, 62 cases treated with PELD using an interlaminar approach due
to lumbar disc herniation were examined. The mean age of the subjects was 40.1 years (18-70) and the mean follow up period
was 32.6 months (24-44). Thirty-four and 28 herniated discs were extracted from L4-L5 and L5-S1, respectively. The clinical
results were evaluated using MacNab’s criteria.
Results: The herniated discs were accessible in all cases. Excellent and good results were obtained in 85% (53 cases) of patients
but 15% of patients (9 cases) showed unsatisfactory results or needed revision. There were 4 cases of incomplete removal, 2 cases
of recurrence and 4 cases of persistent low back pain due to associated degenerative pathologies. Additional surgery was
required in 7 cases which were open discectomy in 5 cases (3 cases of 4 incomplete removal and 2 of recurrence). There was one
case of PLIF and 1 additional decompression. Cauda equina syndrome occurred in one case who underwent subsequent wide
decompression and open discectomy.
Conclusions: interlaminar PELD using endoscopic laminotomy is an effective method for treating lumbar disc herniation with
moderate up and down migration. The clinical success rate can be improved by selecting patients with accessible discs and
excluding those with an associated pathology.

영어초록

Study Design: Retrospective study
Objectives: This study examined the post-operative results of interlaminar percutaneous endoscopic lumbar discectomy (PELD)
with or without endoscopic laminotomy in lumbar disc herniation.
Summary of Literature Review: In addition to the technical feasibility, the indications of PELD surgery are usually the same as
those for open discectomy.
Materials and Methods: From January 2005 to August 2006, 62 cases treated with PELD using an interlaminar approach due
to lumbar disc herniation were examined. The mean age of the subjects was 40.1 years (18-70) and the mean follow up period
was 32.6 months (24-44). Thirty-four and 28 herniated discs were extracted from L4-L5 and L5-S1, respectively. The clinical
results were evaluated using MacNab’s criteria.
Results: The herniated discs were accessible in all cases. Excellent and good results were obtained in 85% (53 cases) of patients
but 15% of patients (9 cases) showed unsatisfactory results or needed revision. There were 4 cases of incomplete removal, 2 cases
of recurrence and 4 cases of persistent low back pain due to associated degenerative pathologies. Additional surgery was
required in 7 cases which were open discectomy in 5 cases (3 cases of 4 incomplete removal and 2 of recurrence). There was one
case of PLIF and 1 additional decompression. Cauda equina syndrome occurred in one case who underwent subsequent wide
decompression and open discectomy.
Conclusions: interlaminar PELD using endoscopic laminotomy is an effective method for treating lumbar disc herniation with
moderate up and down migration. The clinical success rate can be improved by selecting patients with accessible discs and
excluding those with an associated pathology.

참고자료

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