• World Neurosurg · Dec 2019

    Full-Endoscopic Interlaminar Lumbar Discectomy: Retrospective Review of Clinical Results and Complications in 545 International Patients.

    • Kanthika Wasinpongwanich, Krit Pongpirul, Lwin Khin Myat Myat KMM Spine Institute, Bumrungrad International Hospital, Bangkok, Thailand., Withawin Kesornsak, Verapan Kuansongtham, and Sebastian Ruetten.
    • Spine Institute, Bumrungrad International Hospital, Bangkok, Thailand; School of Orthopedics, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand.
    • World Neurosurg. 2019 Dec 1; 132: e922-e928.

    BackgroundMinimally invasive techniques have been developed to provide access to the disc with better visualization while causing less muscle trauma and its consequences. This study was aimed at evaluating the clinical outcomes and complications of the fully endoscopic lumbar discectomy interlaminar approach in a large number of patients.MethodsPatients diagnosed with lumbar herniated nucleus pulposus who underwent fully endoscopic interlaminar lumbar discectomy between 2011 and 2016 were reviewed. Perioperative data, preoperative and postoperative Oswestry Disability Index (ODI) scores, visual analog scale (VAS) back pain scores, VAS leg pain scores, and complications were evaluated and recorded at 1 week and 3 and 6 months postoperatively and each year thereafter.ResultsThe study cohort comprised 545 patients (average age, 46.43 years; 34.31% female). The affected levels were L2-3 in 1.47%, L3-4 in 6.96%, L4-5 in 49.45%, and L5-S1 in 44.69%. Mean preoperative ODI, VAS back pain score, and VAS leg pain score were 43.00%, 5.00, and 5.69, respectively. Postoperative ODI at 1 month was reduced to 15.59% and remained within a range of 14.83%18.32% throughout follow-up. Postoperative VAS back and leg pain score results at 1 week were decreased to 1.66 and 1.79, respectively, and remained at 1.89-3.14 and 1.59-2.66, respectively, throughout follow-up. Sixty-six recurrences (12.11%) were diagnosed. Intraoperative complications were nerve root-related (n = 3) and dural tear (n = 1). Postoperative complications included numbness (n = 18), weakness (n = 5), and residual disc (n = 1). No infections or hematomas were reported.ConclusionsFully endoscopic interlaminar lumbar discectomy is a safe, effective option for treating lumbar disc herniation, with a long recurrence-free recovery.Copyright © 2019 Elsevier Inc. All rights reserved.

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