EARLY RESULTS OF TRANSFORAMINAL PERCUTANEOUS ENDOSCOPIC LUMBAR DISCECTOMY UNDER LOCAL AND SEDOANALGESIA

Abstract

Objective: After the first description of percutaneous posterolateral nucleotomy by Kambin in 1973, transforaminal percutaneous endoscopic lumbar discectomy (PELD) was developed and its use has been increasing in recent years. To describe the surgical technique and anesthesia protocol of transforaminal PELD under local and sedoanelgesia in patients with lumbar disc herniations (LDH) and to report our early results. Materials and Methods: We included 20 patients who underwent transforaminal PELD under local and sedoanalgesia within a period of two months between January 2019 and February 2019 and who had at least a three-month postoperative follow-up period. LDH was at L4-5 in 28.6% of the patients, at L5-S1 in 33.3% of the patients, at L3-4 in 14.3% of the patients, both at L4-L5 and L5-S1 levels in 14.3% of the patients, and at L2-L3 in 1 patient. Results: The mean preoperative Visual anolog scale (VAS) score was 9.4±1.8 (range=8-10) and the mean early postoperative VAS score was 1.85±1.2 (range=0-6). During follow-up, recurrent LDH was seen in 2 patients. One patient developed epidural fibrosis. The mean VAS scores were found to be 1.8±1.69 at the third month follow-up. There was a significant difference between the preoperative VAS scores and the VAS scores in the early postoperative and third month follow-up (p<0.001). Conclusion: Transforaminal PELD under local and sedoanalgesia is an alternative method to classical microdiscectomy in patients with LDH. It is a crucial advantage that it does not require general anesthesia and that patients can provide feedback during surgery.