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      Removal of calcified lumbar disc herniation with endoscopic-matched ultrasonic osteotome - Our preliminary experience.

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          Abstract

          Objective: To evaluate the clinical efficacy, practicability, and safety of an ultrasonic osteotome for percutaneous transforaminal endoscopic discectomy (PTED) in patients with calcified lumbar disc herniation (CLDH).Methods: A total of 25 CLDH patients who underwent PTED at our department between December 2017 and August 2018 were analyzed retrospectively. Post-operative lumbar spine CT was used to evaluate residual calcification. Efficacy was evaluated by pre- and post-operative with the pain visual analog scale (VAS), Oswestry disability index (ODI), and the Modified MacNab Scale; the incidence of intra- and postoperative complications was also analyzed.Results: All procedures were successfully completed and none of the patients was lost to follow-up. Postoperative CT verified the successful removal of calcified protrusions. VAS and ODI scores improved significantly after surgery. Based on the Modified MacNab scale, >90% patients achieved good or excellent outcomes. There were no complications such as dural tear and infection. Seven patients had varying degrees of postoperative dysesthesia. One patient experienced recurrence of herniation within 1 week after operation; successful recovery was achieved after repeat PTED.Conclusions: Use of this ultrasonic osteotome for PTED facilitated effective removal of calcified disc protrusion, relieved nerve compression, and protected the adjacent neurovascular tissues. The instrument may help expand the indications for endoscopic surgery and avoid open surgery for some CLDH patients.

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          Author and article information

          Journal
          Br J Neurosurg
          British journal of neurosurgery
          Informa UK Limited
          1360-046X
          0268-8697
          Feb 2020
          : 34
          : 1
          Affiliations
          [1 ] Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China.
          Article
          10.1080/02688697.2019.1687850
          31718310
          67c23952-6642-4683-8bcd-91dc74429032

          ultrasonic osteotome,Percutaneous transforaminal endoscopic discectomy,calcified lumbar disc herniation,complication

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