A Retrospective Review of Failed Percutaneous Transforaminal Endoscopic Discectomy

Clinical Article

Korean J Spine 2005;2(3): 237-242.

Youn-Sang Sung, M.D.

Department of Neurosurgery, 21^st Century Hospital, Seoul, Korea

A Retrospective Review of Failed Percutaneous Transforaminal Endoscopic Discectomy

Youn-Sang Sung^, M.D.

Abstract

Objective: A retrospective review to determine the causative factors in 66 patients with failed PTELD was conducted.
Materials and Methods: Sixty-six of 800 patients(8.3%) were classified into fair and poor outcome between 1999 and 2003 according to the outcome criteria proposed by Macnab. The ratio of male to female patients was 1:2.6. The patients' ages at the time of PTELD ranged from 18 to 54 years with a mean age of 35 years. All patients had regular clinical or imaging follow up for a minimum of 12 months(range: 12節59 months, mean=33 months)
Results: Twenty patients(30%) had inadequate indications for PTELD(19: combined spinal canal stenosis, 1: preoperative wrong diagnosis). Seventeen patients(26%) were classified into treatment failure due to the procedural problem during endoscopic discectomy(12: incomplete removal of disc herniations, 5: fascicular damage of spinal nerve root) and delayed herniation was observed in fifteen patients(23%). The remaining causes were postoperative discitis and extremity dysesthesia
Conclusion: The author believes PTELD should be performed under strict surgical indications following enough learning periods of this procedure.

Keywords: Herniated lumbar disc.Percutaneous transforaminal endoscpoic lumbar discectomy(PTELD)