Optimal approach for total endoscopic discectomy and its effect on lumbar and leg function in patients with disc herniation

BACKGROUND Disc herniation(DH)is a fragment of the disc nucleus that is pushed out of the annulus into the spinal canal due to a tear or rupture in the annulus.It is a common cause of lumbar and leg pains.Substantial advancements have been made to determine the cause of DH and to ensure accurate diagnosis,imaging,and treatment of this condition.Total endoscopic discectomy is an alternative surgical technique that is less invasive.AIM To study the optimal approach for a total endoscopic discectomy and its influence on lumbar and leg function in DH patients.METHODS This prospective study enrolled 120 patients with lumbar DH who were treated in our hospital from February 2018 to January 2021.All patients were randomly divided into the following two groups:The observation group,comprising 62 patients who underwent surgery using the interlaminar approach,and the control group,comprising 58 patients who were operated through the foramina approach.The treatment effects,perioperative indicators,functional recovery,pain,and quality of life were compared between the two groups.RESULTS The treatment effect in the observation group(93.55%)was significantly better than that in the control group(77.59%).There was no difference in the operative time and intraoperative blood loss amount between the two groups(P>0.05).The hospitalization time of the observation group(4.34±1.33 d)was significantly shorter than that of the control group(5.38±1.57 days)(P<0.05).The Japanese Orthopaedic Association and Oswestry Disability Index scores decreased significantly in both groups after treatment,but the scores were lower in the observation group than in the control group.The visual analog scale scores of the lower back and legs of the two groups were significantly reduced after treatment,but scores were lower in the observation group(2.18±0.88 in the lower back and 1.42±0.50 in the leg)than in the control group(3.53±0.50 in the lower back and 2.21±0.52 in the leg).A short form of the Arthritis Impact Measurement Scales 2 measurement scale(AIMS2-SF)score and Barthel index of the lower back of the two groups increased significantly after treatment,with the observation group having a significantly higher AIMS2-SF score(95.16±1.74)and Barthel index(97.29±1.75)than the control group(84.95±2.14 and 89.16±2.71,respectively)(P<0.05).CONCLUSION Through total endoscopic discectomy with the interlaminar approach,the degree of pain in the waist and leg was reduced,and the lumbar function considerably recovered.

Endoscopic push through tragal cartilage tympanoplasty: A 10-year retrospective review of our technique and outcomes

BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.