The efficacy of modified percutaneous endoscopic interlaminar discectomy in the treatment of L5/S1 disc herniation

English Keywords:Percutaneous endoscopic lumbar discectomy  Lumbar disc herniation  Modified interlaminar approach  Ligamentum flavum  Minimally invasive

English Abstract:

  【Abstract】 Objectives: To evaluate the clinical outcome of modified percutaneous endoscopic interlaminar discectomy(MPEID) in the treatment of L5/S1 disc herniation. Methods: All 123 patients diagnosed of L5/S1 disc herniation(65 males and 58 females, age from 16 to 83 years, mean age 44.43±12.67 years) were treated with MPEID in our spine surgery center. Visual analogue scale(VAS) was scored before operation, after operation and at the last follow-up. Oswestry disability index(ODI) was evaluated before operation and at the last follow-up. The clinical effect was assessed according to the modified Macnab standard at the final follow-up. Results: Operations were successfully completed in all the 123 patients. The operation time was 45.96±21.87min. The intraoperative blood loss was 5.93±3.15ml. All patients were followed up for 6-35 months(16.49±7.30 months). 8 cases occurred postoperative complications, with an incidence of 6.5%. There were 3 cases of recurrence, with a recurrence rate of 2.4%. The pre-operative, post-operative and final follow-up VAS scores were 5.29±1.71, 2.89±0.75, and 0.59±0.72, respectively(P<0.05). The last follow-up ODI improved significantly(P<0.05). According to the modified MacNab criteria, 100 cases were excellent, 20 cases were good, 2 cases were fair, and 1 case was poor. The excellent and good rate was 97.6%(120/123). Conclusions: MPEID has a satisfactory early clinical outcome in the treatment of L5/S1 disc herniation, whichpreserves the ligamentum flavum.