• Takeshi Kaneko, Yuichi Takano, and Hirohiko Inanami.
• Inanami Spine and Joint Hospital, Higashishinagawa, Shinagawa-ku, Tokyo, Japan.
• Medicine (Baltimore). 2021 Jun 25; 100 (25): e26385e26385.

RationaleFor isthmic lumbar spondylolisthesis (ILS) associated with the removal of herniation, it remains challenging to perform less invasive and minimally disruptive procedures. Good results could potentially be obtained by further preserving the posterior elements in full-endoscopic lumbar discectomy (FESS), which is less invasive than microenscopic surgery (MES).Patient ConcernsOne patient complained of left leg pain, and another patient complained of right leg pain and low back pain.DiagnosesTwo patients with ILS and Meyerding Grade 1 lumbar spondylolisthesis.InterventionsWe performed a full-endoscopic lumbar discectomy via the interlaminar space (FESS-IL) for L5/S1 lumbar disc herniation (LDH) accompanied by isthmic lumbar spondylolisthesis. FESS-IL was performed in 2 patients with radiculopathy caused by different types of LDH using a full endoscopic system with a 4.1 mm working channel and 6.9 mm outer diameter. A 3.5-mm diameter high-speed drill was used in one patient for an upward-migrated LDH in the inner-rim of the infravertebral border. The other patient underwent minimal resection without bone resection.OutcomesThe one-year clinical outcome included confirmation of pain relief and evacuation of migrated LDH on magnetic resonance imaging in all patients. There was no progression of slippage on radiography. The mean operative time was 82 min, and no complication was observed. The one-year clinical outcome demonstrated sufficient pain relief.Lessons The Year postoperative outcome showed improvement. We believe that FESS-IL is a viable alternative operative approach for LDH for ILS.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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