Comparative analysis of percutaneous endoscopic interlaminar discectomy and microdiscectomy in patients with overweight

GOAL OF RESEARCH is to compare the effectiveness and assess the advantages and disadvantages of percutaneous endoscopic interlaminar discectomy and microdiscectomy in patients with overweight.
MATERIALS AND METHODS: The response to treatment of 20 patients with intervertebral disk disease L_IV–L_V with overweight in the 2018–2019 timeframe who underwent microdiscectomy L_IV–L_V (group 1) and percutaneous endoscopic interlaminar discectomy L_IV–L_V (group 2) on the basis of Polenov Neurosurgical Research Institute, branch of the Almazov National Medical Research Centre and Multidisciplinary Pirogov clinic have been analyzed. The duration of surgical measure, period of hospital treatment, pain severity according to VAS in preoperative and postoperative period have been evaluated.
RESULTS: The average severity of preoperative radicular and axial pain according to VAS decreased from 7.8±1.2 and 3.7±1.3 to 1.6±0.5 and 2.0±0.5 in the first group and from 7.6±1.3 and 3.8±1.4 to 1.4±0.5 and 1.6±0.3 in the second group. The average duration of surgical intervention in the first group made 90 minutes (60–120 minutes), in the second group — 52 minutes (35–80 minutes). Patients of the first group could be out of bed in 10 hours (up to 18 hours), patients of the second group — in 3 hours after surgery. The average length of stay in hospital of patients in the first group made 5 full days, in the second — 3 full days.
CONCLUSION: Percutaneous endoscopic interlaminar discectomy in patients with overweight is as effective as standard microdiscectomy and allows to achieve regression of radicular pain syndrome. At the same time the use of technique of percutaneous endoscopic interlaminar discectomy can reduce the duration of surgical intervention and surgical injury, and so ensure immediate mobilization of the patient, which helps to prevent complications in patients with overweight.

1. Официальный сайт Европейского регионального бюро ВОЗ http://www.euro.who.int/ru

2. Zhou B. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants / Zhou B, Bentham J, Di Cesare M, Bixby H. at al.// Lancet — 2017, Jan 7, 389:37–55.

3. Hangai M, Kaneoka K, Kuno S, et al. Factors associated with lumbar intervertebral disc degeneration in the elderly. Spine J. 2008; 8: 732–740.

4. Samartzis D, Karppinen J, Chan D, et al. The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: a populationbased study. Arthritis Rheum. 2012; 64: 1488–1496.

5. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. — 2000. — P. 253.

6. Li, X. Percutaneous endoscopic lumbar discectomy for lumbar disc herniation / X. Li, Y. Han, Z. Di [et al.] // Journal of Clinical Neuroscience. — 2016. — Vol. 33. — P. 19–27.

7. Мержоев А. М. Перкутанная эндоскопическая поясничная дискэктомия — интерламинарный доступ / Мержоев А. М., Гуляев Д. А., Давыдов Е. А., Сингаевский С. Б., Пришвин А. П. // Российский Нейрохирургический журнал имени профессора Поленова А. Л. — 2017 — Т. IX. — № 1 — С. 49–56.

8. Олейник Е. А. Выявление разновидности формы поясничного остеохондроза в отдаленном послеоперационном периоде / Олейник Е. А., Олейник А. А., Орлов А. Ю., Давыдов Е. А., Олейник А. Д., Иванова Н. Е. // Вестник Всероссийского общества специалистов по медико-социальной экспертизе, реабилитации и реабилитационной индустрии. — 2018. — № 4. — С. 91–97.

9. Головин К. Ю. Хирургическое лечение дегенеративно-дистрофических заболеваний поясничного отдела позвоночника у лиц с избыточной массой тела и ожирением / Головин К. Ю., Аганесов А. Г., Хейло А. Л., Гурова О. Ю. // Хирургия позвоночника. —2013. — № 3. — С. 53–61.

10. Kapetanakis S., Gkantsinikoudis N., Chaniotakis C., et al. Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation in Obese Patients: Health-Related Quality of Life Assessment in a 2-Year Follow-Up. World Neurosurg. 2018 May; 113: 638–649.