J Neurol Surg A Cent Eur Neurosurg 2015; 76 - A066
DOI: 10.1055/s-0035-1566385

Full-Endoscopic Interlaminar versus Microsurgical Operations in Lumbar Compressive Lesions Surgery

Marko Marković 1, Nenad Živković 1, Vuk Aleksić 1
  • 1Clinical Hospital Center Zemun, Belgrade, Serbia

Introduction Full-endoscopic operations of lumbar spine are truly minimally invasive surgical procedures. Endoscopic techniques have become the standard in many areas because of the advantages they offer intraoperatively and after surgery. With the interlaminar and transforaminal approach, two full-endoscopic procedures are available for lumbar compressive lesion operations.

Aim To present and explain all aspects of the full-endoscopic operative technique and presentation of results of lumbar discectomies and monosegmental decompression in full-endoscopic interlaminar technique in comparison with conventional microsurgical operations performed during 3-year period.

Material and Methods A series of 372 patients underwent full-endoscopic interlaminar lumbar discectomy and 43 patients with full-endoscopic interlaminar decompression for monosegmental spinal canal stenosis comparing 280 patients with microdiscectomy and spinal canal decompression, during a 3-year period, is analyzed. In addition to general and specific parameters, VAS and ODI scale are used as a measuring instrument.

Results In the full-endoscopic group, 88% of the patients no longer had leg pain, and 9% had only occasional pain, postoperatively. No serious surgical complications were observed. In three patients, minor nerve damage resulted in transient paresthesias, and in three patients transient liquorrhea is observed. The recurrence rate was 5.8%. Resection of the herniated disc and sufficient decompression was technically possible in all cases. The full-endoscopic technique brought significant advantages in the following areas: back pain, rehabilitation, complications, and traumatization.

Conclusion The clinical results of the full-endoscopic technique are superior to those of the conventional microsurgical discectomy with advantages such as reduced traumatization, improved patient mobility, and back pain minimization. With the possibility of selecting the most adequate approach, lumbar disc herniations inside and outside the spinal canal, and other monosegmental compressive lesions, can be sufficiently removed using the full-endoscopic technique, when taking the appropriate indication criteria into account.

Keywords full-endoscopic discectomy; interlaminar decompression; microdiscectomy; monosegmental stenosis