Mid-term clinical outcomes of full-endoscopic interlaminar approach for lumbar disc herniation
WANG Bing
L Guo-hua
LI Ya-wei
LI Lei
KUANG Lei
ZHOU Qian
LI Peng-z
Abstract：Objective To evaluate the mid-term clinical outcomes of full-endoscopic ( FE ) interlaminar approach for lumbar disc herniation. Methods A retrospective study of 45 patients with lumbar disc hernation undergoing FE interlaminar approach from August 2008 to February 2010 was carried out. There were 25 males and 20 females, whose mean age was 38.3 years old ( range:19-58 years ). The Visual Analogue Scale ( VAS ) of low back pain and leg pain and Oswestry Disability Index ( ODI ) were evaluated preoperatively, at 3 months and 1 year after the operation and in the latest follow-up. The modiifed Macnab criteria was used to assess the clinical outcomes, and all the data was statistically analyzed. Results The operation was successfully completed in all the patients. The mean operation time was 62.4 min, and the mean length of hospital stay was 5.2 d. Small dural tears were noticed during the operation in 2 patients, which were not handled. There were no nerve root injuries or postoperative blood loss. All the patients were followed up from 48 to 66 months. The VAS score of leg pain was ( 7.6±1.6 ) points preoperatively, which was reduced to ( 1.2±0.8 ), ( 1.1±0.9 ) and ( 1.6±1.2 ) points at 3 months and 1 year after the operation and in the latest follow-up respectively ( P<0.01 ). No statistically signiifcant differences existed between the scores in the latest follow-up and that at 1 year after the operation ( P>0.05 ). The VAS score of low back pain was ( 3.1±2.2 ) points preoperatively, which was reduced to ( 1.8±1.5 ), ( 1.6±1.4 ) and ( 1.7±0.9 ) points at 3 months and 1 year after the operation and in the latest follow-up respectively ( P<0.01 ). No statistically signiifcant differences existed between the scores in the latest follow-up and that at 1 year after the operation ( P>0.05 ). The ODI score was ( 69.5±10.5 ) points preoperatively, which was reduced to ( 19.3±6.5 ), ( 15.6±5.9 ) and ( 21.8±7.0 ) points at 3 months and 1 year after the operation and in the latest follow-up respectively ( P<0.01 ). No signiifcant differences existed between the scores in the latest follow-up and that at 1 year after the operation ( P>0.05 ). In the latest follow-up, good subjective satisfaction was noticed in 93.3%of the patients, and the clinical excellent and good rate was 88.9%. There was no correlation between the results based on the modiifed Macnab criteria and the gender, age, type of disc herniation and preoperative low back pain ( P>0.05 ). However, significant correlation was found between the results based on the modified Macnab criteria and the preoperative Pifrrmann grading, sensation deifcits and surgical segments ( P<0.05 ). A patient with L4-5 disc herniation had worsened lower limb numbness at 1 week after the operation, who underwent dehydration and hormonotherapy and got relieved at 2 weeks after the traditional treatment. Reherniation of the surgical disc was detected at 4 months after the operation in 1 patient with L5-S1 disc herniation, who then received small-incision open surgery. In the latest follow-up, mild dyskinesia occurred to 2 patients and paresthesia to 6 patients, which were obviously improved when compared with the preoperative symptoms. Conclusions Satisfactory mid-term clinical outcomes can be achieved by FE interlaminar approach for lumbar disc herniation, with the advantages of less trauma, blood loss and complications and rapid postoperative recovery.
Keywords：Intervertebral disc displacementEndoscopyLaminectomyLumbar vertebraeSurgical proceduresminimally invasive
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 603-607 )