BEYOND THE MYTH: HIGH MIGRATED LUMBAR DISCS EFFECTIVELY TREATED WITH ENDOSCOPIC SURGERY: A TWO YEAR PROSPECTIVE STUDY
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Keywords
Endoscopic spine surgery, high migrated lumbar discs, lumbar disc herniation, prospective study, surgical outcomes
Abstract
Introduction: Even though Full Endoscopic Lumber Discectomy outcomes are now better than those of traditional open surgery due to advancements in technology and different approaches, however, managing high-grade migrating discs is still challenging.
Objective: This study aimed to determine the outcomes of FELD for patients with high-grade migratory disc herniation.
Material and Methods: This prospective two years observational study included patients operated by full endoscopic spine surgery using interlaminar approach with symptomatic high-grade migrating lumbar disc herniation at different disc levels.Zones 1 and 4 migration were regarded as high-grade migration and were included in the study. A full-endoscopic interlaminar approach was carried out. The improvement in functional outcomes, as measured by the Visual Analog Scale (VAS) for pain and the Oswestry Disability Index (ODI), was the main outcome measure. The modified Mac Nab criteria were used to evaluate spinal surgery outcomes.
Results: A total of 442 endoscopic lumbar surgeries were performed out of which, 47 (11%) procedures were carried out to treat highly migratory disc herniations. 14 (30%) of these highly migratory disc herniations were upward, while 33 (70%) migrated downward. The mean preoperative back pain VAS score was 7.8 ± 1.2. which was dropped to 3.2 ± 1.0 (p < 0.001) at the 6-month follow-up and a further 2.5 ± 0.9 (p < 0.001) at the 1-year follow-up. 92 (76.7%) patients reported excellent outcomes using the modified MacNab criteria.
Conclusion: Full endoscopic spine surgery is an effective management strategy for high migrating lumbar disc herniations, with good results in terms of pain reduction and functional recovery. This method provides a less invasive option that leads to fewer surgical problems and faster recovery.
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Muhammad Farooq
Consultant Neurosurgeon,Farooq Endocopic spine clinic,Peshawar General Hospital,Peshawar,Pakistan
Naeem Ul Haq
Consultant Neurosurgeon, Neurosurgery Department Mardan Medical Complex, Mardan, Pakistan
Tabrez Wali Shah
Senior Registrar,Neur osurgery Department, Peshawar General Hospital, Peshawar, Pakistan
Shahid Nawaz
Associate Professor Neurosurgery, Gomal Medical College, D.I Khan, Pakistan
Mumtaz Ali
Professor,Neuro surgery Department, Irfan General Hospital,Peshawar, Pakistan
Naveed Noor
Medical Officer,Rehman Medical Institute, Peshawar, Pakistan
Abdul Haseeb Sahibzada
Research Officer, Farooq Endocopic spine clinic, Peshawar General Hospital, Peshawar, Pakistan