Title: The endoscopical transforaminal discoplasty for primarily back-pain

Author: Thomas Hoogland, Munich, Germany

 

Purpose of the study:

Aim of this prospective randomised study was to evaluate the efficiency of the endoscopic transforaminal discoplasty in prolapsed disc with primarily back pain.

 

Material:

From June 1994 until June 2000 183 with degenerative disc-disease and primarily back-pain were treated with an endoscopic transforaminal decompressive discoplasty, consisting of a small hole decompression of the prolapsed and degenerative posterior part of the disc and a endplate-abrasion. The average age was 44 Years, youngest 17 oldest 65, there were 64 female and 108 male patients. At two years 172 patients fulfilled a follow-up by questionnaire (94%).

 

Method:

First a discography of at least 2 levels was done to confirm the typical pain response and anular rupture and to exclude a massive dye leakage. Then cannulas with increasing diameters were introduced over a guiding wire. With special hollow fasers up to 7,5 mm, the lateral foramen was enlarged in the direction of the posterior disc area. The fragments were removed with special forceps´and with special curettes and an awl the inferior endplate was perforated, abraded and cleaned out. The dura and the nerve roots were controlled endoscopically and the instrumentation was removed.

 

Results:

At the two year follow-up 76%  of the patients reported an excellent or good result, 15% fair and 9% an unsatisfactory result. Only 2 patients reported some increase of the back-pain. There was one case of discitis. Seven patients (4%) needed re-operations. At two years 76 % of the patients had an excellent or good result, 15 % a fair and 9 % an unsatisfactory result.

 

Conclusion:

The endoscopical transforaminal decompressive discoplasty is an effective treatment for degenerative disc-disease with primarily low back-pain.