Interlaminar Percutaneous Endoscopic Lumbar Discectomy: Rotate and Retract Technique

Abstract

Interlaminar percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive technique to treat soft disc herniation. However, the currently used single working channel does not allow for safe nerve root retraction. This study aims to describe the rotate and retract technique for safe nerve root retraction during L5-S1 interlaminar PELD. A total of 17 patients who underwent interlaminar PELD with the rotate and retract technique between November 2016 and August 2017 were retrospectively evaluated. Both pre- and postoperative visual analog scale (VAS) scores (back and leg) and Oswestry Disability Index (ODI) scores were used for clinical assessment. The mean preoperative VAS scores for back and leg pain were 3.84 ± 1.15 (range, 2-6) and 8.7 ± 0.2 (range, 8-10), respectively. The mean preoperative ODI score was 64.2 ± 13.2 (range, 48-90). The mean VAS scores for back and leg pain decreased to 1.24 ± 1.34 (range, 0-6) and 1.15 ± 0.65 (range, 0-4), respectively, at the last follow-up (P < 0.001). The mean ODI score also improved to 13.2 ± 5.1 (range, 9-29) at the last follow-up (P < 0.001). The rotate and retract technique for interlaminar PELD is an effective maneuver for the treatment of L5-S1 disc herniations in selected patients if performed by experienced surgeons.