Clinical evaluation for the transforaminal endoscopic hernia of the intervertebral disc of the lumbosacral spine with puncture nucleoplasty

Transforaminal endoscopic hernia removal is currently one of the most effective and relatively safe methods of treating an intervertebral hernia of the lumbosacral spine. In the current study we aim to evaluate the effectiveness of transforaminal endoscopic discectomy in combination with puncture nucleoplasty as a surgical protocol to treat hernias of the lumbosacral spine. 87 patients (43 men and 44 women) aged 19 to 62 years were enrolled in our study and underwent proper evaluation. The duration of follow-up in the postoperative period averaged 18.7 ± 6 months (from 7.2 to 28 months). To assess the clinical effectiveness of the performed surgical interventions, the dynamics of the pain syndrome was analyzed using a visual analogue scale (VAS). Patient status, pain and disability were assessed using Oswestry Disability Index (ODI). Postoperative complications were also analyzed to evaluate the results of the operation. Moreover, objective criteria were used to assess the level of pain and the degree of disability. All patients showed a decrease in pain intensity and an improvement in the vital signs. Long follow up for ODI within six months after the operation showed a significant decrease by two to three times. Due to the lack of similar studies (endoscopy plus nucleoplasty), the results of our work were compared with the results of endoscopic hernia removal without nucleoplasty. However, in the evaluated patients, some intra- and postoperative complications were observed. In conclusion, the use of puncture nucleoplasty as the second stage of minimally invasive hernia removal of muscle tension dysphonia (MTD) is an effective treatment method, significantly reducing the recurrence rate of the disease.