Endoscopic discectomy via interlaminar approach assisted by expanding fenestration for L5/S1 lumbar disc herniation combined with narrowing of interlaminar space

English Keywords:Lumbar disc herniation  Endoscopic discectomy  Expanding fenestration  Interlaminar approach

English Abstract:

  【Abstract】 Objectives: To evaluate the feasibility of endoscopic discectomy via interlaminar approach for the L5/S1 lumbar disc herniation with narrowing of interlaminar space assisted by expanding fenestration which is preliminarily prepared using conventional instruments. Methods: 45 patients suffering from L5/S1 lumbar disc herniation with narrowing of interlaminar space underwent endoscopic discectomy via interlaminar approach assisted by expanding fenestration, which was preliminarily prepared using conventional instruments from September 2011 to June 2012. There were 29 males and 16 females with a mean age of 35.7(range, 16-53 years) years old. The pathological types included nerve root shoulder type in 25 cases, axillary type in 10 cases, mixed type in 5 cases and sequestration in 5 cases. The clinical evaluations of operation time, intraoperative blood loss, resected bone mass and complication were reviewed. All patients were assessed by visual analog scale(VAS) for lumbar and leg pain during the periods of preoperation, postoperation 3 days, 2 weeks, 1 month, 3 months and 6 months respectively. Results: All patients were followed up at 3d, 2w, 1m, 3m, and 6m. The average operation time was 83.5 minutes(range 60-125 minutes). Intraoperative blood loss was 10-50ml(average 25ml). There was no nerve root or dural sac injury, no infection was noted. The resected bone mass was about 3-10g(average 6g). There was a significant improvement in VAS leg pain scores after surgery compared with preoperative ones(P<0.05). Conclusions: Endoscopic discectomy via interlaminar approach assisted by expanding fenestration for L5/S1 lumbar disc herniation combined with narrowing of interlaminar space is safe and reliable, necessitating less complicated and expensive equipment.