Abstract
Objective To discuss the clinical effects of the percutaneous endoscopic discectomy of L_5S_1 disc herniation through different approaches: postlateral transforaminal and interlaminar approach. Methods From June 2003 to October 2008, 57 patients with L_5S_1 disc herniation were included in the study. There were 32 males and 25 females, with a mean age of 42, ranging from 17 to 79.22 patients un-derwent percutaneous endoscopic diseectomy through postlateral transforaminal approach while the other 35 patients through interlaminar approach. Oswestry Function Index was used to evaluate preoperative and post-operative lumbar vertebrae, function. The clinical outcome, indications and the risk of secondary operation of two approaches were analyzed. Results All of the patients had followed up, with an average period of 13.4 months, ranging from 12 to 64 months. There is no difference in age and blood loss during operation in two groups. One revision were needed in each groups. One ease of postoperatve infection was found in each group. When far lateral disc herniations were identitied postlateral transforaminal approach was applied, the high iliac crest had to be considered. When intracanalicular disc herniations at the L_5S_1 level were found, Interlaminar approach was suitable. For postlateral transforaminal approach , the average OFI had improved from 74.36 to 13.91. For interlaminar approach, the average OFI had improved from 77.45 to 12.56. There is no difference in OFI between the two groups According to MacNab's criteria, Overall excellent-to-good re-sults were 86% and 89% in the patients underwent postlateral transforaminal approach and those underwent interlaminar approach. Conclusion Both postlateral transforaminal approach and interlaminar approach are safe, effective, and minimally invasive procedure for the treatment of disc herniations at the L_5S_1 level in properly selected cases. Key words: Lumbar vertebrae; Intervertebral disk displacement; Endoscopy
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