Abstract
Introduction The role of surgery by minimally invasive techniques for lumbar disc disease remains
unclear in the Cochrane review. There are reports of significant advantages of endoscopy
over open or microdiscectomy techniques, such as better visualization of the lesion,
smaller incision sizes with lower short-term morbidity, reduced hospital stay, and
better education.
Materials and Methods Four hundred consecutive lumber disc herniation patients underwent endoscopic interlaminar
lumbar discectomy from January 2006 to December 2010 by single surgeon by Destandu
system (Karl Storz, Germany). Single-level and double-level disc with unilateral or
bilateral symptoms (including central, sequestrated, or migrated disc) were included.
Visual analog scale (VAS) scores for back pain and leg pain and MacNab criteria were
recorded pre- and postoperatively.
Results The mean VAS score before surgery was 7.9 as compared with a 1.5 score 3 months after
surgery. Postoperative VAS scores were significantly better in 90% of cases. Overall,
91% of patients had good-to-excellent results according to MacNab criteria. Accidental
intraoperative single-facet injury, minor dural tear, recurrence, postoperative discitis,
and persistent paresthesia were seen in 3, 7, 2, 2, and 1 patients, respectively.
The mean follow- up was 24 months (range 10 months to 5 years).
Conclusions Endoscopic interlaminar technique (ILT) was a safe and effective alternative procedure
for lumber disc disease. This was associated with some complications, especially in
the initial learning curve. Once the practitioner is over the learning curve and has
acquired expertise, this procedure was safe and effective.
Keywords
lumbar disc herniation - spinal endoscopy - percutaneous lumbar disc decompression
- endoscopic lumbar discectomy
