Primary study of full-endoscopic interlaminar approach for lumbar disc herniation

English Keywords:Lumbar disc herniation  Endoscopy  Discectomy  Interlaminar approach

English Abstract:

  【Abstract】 Objective：To evaluate the primary outcome of full-endoscopic（FE） interlaminar approach for lumbar disc herniation.Method：A retrospective study of 30 cases including 16 males and 14 femles undergoing full-endoscopic interlaminar approch due to lumbar disc hernation from Aug. 2008 to Feb. 2009 was carried out，the age ranged from 20-52 years（mean 36.1 years）.All patients had single level involved，with 24 in L5/S1 and 6 in L4/5.The mean course of disease was 66 days.All patients presented back pain and sciatica of varied degree，and MRI examination was performed in all patients before surgery.The pathological type of disc herniation included：18 lateral，8 paramiddian and 4 prolapse.The complications，operating time，blood loss and clinical outcome were reviewed retrospectively.The visual analogue scale（VAS） was used to evaluate the leg pain and back pain.Result：2 cases eventually experienced open surgery due to failed primary operation，and 2 cases had dural matter teared.No serious complication such as postoperative bleeding and nerve injury was noted.The average operating time was 70.7min（range，45-105min） with little blood loss.The mean hospital stay was 5.7d（range，3-7d），no infection was noted in any case，26 cases had leg pain relieved completely after operation，2 case only had partial relief.Patients were followed up for an average of 1.3 years（range，1.0-1.5 years） and no recurrence was noted thereafter.VAS for leg pain was 76.8mm，7.6mm and 7.3mm for preoperative，3 months and final follow-up respectively，which showed significant difference between preoperative and postoperative（P<0.01），while no difference between two postoperative score（P>0.05）.VAS for back pain was 18.8mm，11.0mm and 10.7mm for preoperative，3 months and final follow-up respectively，which showed significant difference between the preoperative and postoperative（P<0.01），while no difference between two postoperative parameters（P>0.05）.Conclusion：Full-endoscopic interlaminar approach for lumbar disc herniation presents good clinical outcomes due to its minimal invasion，less complications and good prognosis.