Turkish Neurosurgery
The Trans-Superior Articular Process Approach Utilizing Visual Trephine: A More Time-saving and Effective Percutaneous Endoscopic Transforaminal Lumbar Discectomy for Migrated Lumbar Disc Herniation
Liang Qiao1, Jiayuan Liu1, Xuebin Tang1, Haitang Liu1, Dong Wei1, Ziqiang Zhu1, Yunqing Wang1
1The Second Affiliated Hospital of Xuzhou Medical University, orthopaedic, Xuzhou,
2 General Hospital of Xuzhou Mining Group, orthopaedic, Xuzhou,
DOI: 10.5137/1019-5149.JTN.34049-21.3

Aim:To introduce and evaluate the efficacy of the trans-superior articular process (trans-SAP) approach utilizing visual trephine in PETLD for migrated lumbar disc herniation. Material and Methods:This study included 98 patients, 50 patients were in trans-SAP PETLD group and 48 patients were in conventional PETLD group. Visual analogue scale (VAS), Oswestry disability index (ODI), gender, age, blood loss, operation time, the frequency of X-ray fluoroscopy and the percentage of highly migrated herniation were evaluated and compared between the trans-SAP PETLD and conventional PETLD group.Results:In both the trans-SAP PETLD and conventional PETLD group, VAS and ODI were decreased at postoperative 1 day and 3 months compared preoperative (P<0.001). What\'s more, the VAS and ODI of postoperative 3 months were lower than the postoperative 1 day (P<0.001). There was no difference in gender, age, blood loss after the operation, VAS during operation between trans-SAP group and conventional group(P>0.05). The blood loss during the operation of the trans-SAP group was higher (P<0.05), but the operation time and frequency of X-ray fluoroscopy were lower than the conventional group (P<0.001). Last, the trans-SAP group had a higher percentage of highly migrated herniation (P<0.001).Conclusion:Both the conventional way and trans-SAP approach can achieve excellent surgical results. But, in the trans-SAP group, the operation time is shorter, and X-ray fluoroscopy is less. PETLD with visual trephine has more advantages in highly migrated herniation and maybe easier to be mastered by young surgeons.

Corresponding author : Jiayuan Liu