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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(04): 696-700
DOI: 10.1055/s-0045-1809327
Original Article

A Comparative Analysis of Radiographic Intervertebral Disc Height Following Full-Endoscopic Lumbar Discectomy: Interlaminar versus Transforaminal Approach

Authors

  • Tinnakorn Pluemvitayaporn 

    1   Spine Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

  • Supree Vikan

    1   Spine Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

  • Pritsanai Pruttikul

    1   Spine Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

  • Suttinont Surapuchong

    1   Spine Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
    2   Research Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

  • Piyabuth Kittithamvongs

    2   Research Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

  • Warot Ratanakoosakul

    1   Spine Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

  • Kitjapat Tiracharnvut

    1   Spine Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

  • Chaiwat Piyasakulkaew

    1   Spine Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

  • Sombat Kunakornsawat

    1   Spine Unit, Department of Orthopaedic Surgery, Institute of Orthopedics, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
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Abstract

Study Design

This is a retrospective cohort study.

Introduction

Full-endoscopic lumbar discectomy (FELD), a minimally invasive surgical procedure used to treat lumbar disc herniation (LDH), has been shown to be highly effective with fewer complications. This procedure can be performed using the interlaminar (IL) or transforaminal (TF) approach. The IL approach involves more anatomical structures than the TF approach. However, comprehensive data regarding preoperative and postoperative intervertebral disc height (IDH) changes for patients undergoing full-endoscopic discectomy through the IL versus the TF approach is yet to be documented.

Objective

To compare the preoperative and postoperative IDH on radiographs in patients who underwent the FELD using the IL or TF approach.

Materials and Methods

The medical records of patients diagnosed with LDH who underwent FELD between 2014 and 2022 were collected and analyzed. Pre- and postradiographic IDH and clinical scores, including visual analog scale-back pain (VAS-B), Oswestry disability index (ODI), and recurrent LDH, were assessed and compared over a follow-up period of at least 2 years.

Results

A total of 110 patients were included, 82 undergoing the IL procedure and 28 undergoing the TF procedure. The median IDH variance was consistent at 1.0 (interquartile range [IQR] 0.5, 2) for the IL and TF procedures, indicating no significant statistical variance. The IDH ratio was also comparable between the two groups, with the IL group at 84% and the TF group at 85%. However, a notable disparity was observed in postoperative IDH, with a median of 7.5 (IQR 6.5, 8.5) for the IL approach and 8.5 (IQR 7, 9.5) for the TF approach. Importantly, no statistical differences were found in clinical outcomes, including VAS-B, ODI, and recurrent LDH.

Conclusion

After a 2-year follow-up for FELD, there is no significant difference in radiographic outcomes, IDH difference, and IDH ratio between the IL and TF approaches. Additionally, there is no apparent correlation between reductions in IDH and IDH ratio and the decrease in back pain scores (VAS-B) or ODI after the procedures.

Keywords

intervertebral disc height - lumbar disc herniation - radiographic - full-endoscopic lumbar discectomy - interlaminar - transforaminal

Ethical Approval

The study was approved by the ethics committee of Lerdsin Hospital.




Publication History

Article published online:
21 May 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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