The Strategy and Early Clinical Outcome of Percutaneous Full-Endoscopic Interlaminar or Extraforaminal Approach for Treatment of Lumbar Disc Herniation.

Abstract

Objective is to analyze the surgical strategy, safety, and clinical results of percutaneous full-endoscopic discectomy through interlaminar or extraforaminal puncture technique for LDH. Preoperative CT and MRI were analyzed, which were based on the main location of the herniated disc and its relationship with compressed nerve root. Sixty-two patients satisfied the inclusion criteria during the period from August 2012 to March 2014. We use percutaneous full-endoscopic discectomy through different puncture technique to remove the protrusive NP for LDH. Sixty patients completed the full-endoscopic operation successfully. Their removed disc tissue volume ranged from 1.5 mL to 3.8 mL each time. Postoperative ODI and VAS of low back and sciatica pain were significantly decreased in each time point compared to preoperative ones. No nerve root injury, infection, and other complications occurred. The other two patients were shifted to open surgery. No secondary surgery was required and 91.6% of excellent-to-good ratio was achieved on the basis of Macnab criteria at postoperative 12 months. Acquired benefits are fewer complications, rapid recovery, complete NP removal, effective nerve root decompression, and satisfactory cosmetic effect as well. This is a safe, effective, and rational minimally invasive spine-surgical technology with excellent clinical outcome.