Full-endoscopic interlaminar approach discectomy for central lumbar disc extrusion

Objective: To evaluate the safety and efficacy of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of central lumbar disc extrusion via an interlaminar approach.

Methods: Between January 2012 and January 2014, 27 low-back pain patients with radicular central lumbar disc herniations underwent percutaneous endoscopic discectomy through an interlaminar approach. The clinical follow-ups were performed at 3 months, 6 months and 1 year with an extensive postoperative questionnaire, including pain visual analog scale (VAS) and Oswestry disability index (ODI).

Results: Mini-invasive operation was completed successfully in all patients. The mean operative duration was 41 (26-83) min and the average postoperative hospitalization time 5 (2-7) days. The postoperative median VAS and ODI scores significant decreased at all time-points. Twenty-five patients had no longer leg pain. But the recurrence rate of disc herniation stood at 7.4%. One patient undergo reoperation (microscopic discectomy) and another showed a significant relief in pain symptoms after conservative treatment.

Conclusions: Endoscopic discectomy via an interlaminar approach for central lumbar disc extrusion offers significant advantages of faciliating rehabilitation, reducing complications, minimizing trauma and lowering expenditure.