Clinical results of combined interlaminar and transforaminal endoscopic discectomy for central large disc herniation

Abstract

Objective: The purpose of this study was to inscribe the combined interlaminar with transforaminal endoscopic discectomy for central large disc herniation and report clinical results. Methods: Patients diagnosed with large central lumbar herniated nucleus pulposus who underwent combined interlaminar and transforaminal endoscopic discectomy between 2015 and 2020 were reviewed. Perioperative data, preoperative and postoperative Oswestry Disability Index (ODI) scores, visual analog scale (VAS) back pain scores, VAS leg pain scores, and complications were evaluated and recorded at 1 week and 3 and 6 months postoperatively and each year thereafter. Results: The study revealed 9 cases (22.22% female). The average age of patients was 42.33 ± 19.8 years old (range, 18–83 years old). The levels of surgery were L3-4 in 22.22%, L4-5 in 77.77%. This combined approach has an average operative time of 104.44 ± 22.42 min. The VAS Back and Leg were improved from pre-operative score from 5.0 ± 2.0, 4.42 ± 2.93 to 2.18 ± 1.97 and 2.55 ± 2.84 retrospectively at 1 week. The ODI score was improved pre-operative from 46.85 ± 15.61% to 14.94 ± 19.08% at 3 month follow up. There were 2 cases (22.22%) diagnosed of recurrent disc herniation. No case of epidural hematoma, infection, permanent neurological deterioration, cauda equina syndrome. Conclusions: Combined interlaminar and transforminal endoscopic discectomy is an option for central large lumbar disc herniation.

Keywords

• Central large disc herniation
• Combined discectomy
• Full endoscopic discectomy