Application of transiliac approach to intervertebral endoscopic discectomy in L5/S1 intervertebral disc herniation

OBJECTIVE: To discuss the significance and the short-term effect of bone puncture technique in transiliac approach to intervertebral endoscopic discectomy for the treatment of L5/S1 intervertebral disc herniation. METHODS: Nineteen patients were diagnosed as L5/S1 disc herniation and treated using transiliac approach to endoscopic discectomy (group I), and 20 patients were diagnosed as non-L5/S1 disc herniation and underwent conventional approach (group R). Leg pain was evaluated by VAS. MacNab ratings of the last follow-up were recorded to evaluate early clinical efficacy, and postoperative complications were recorded to evaluate surgical safety. The imaging changes of the patients 3 months after surgery were observed. RESULTS: One patient in group I, who felt abnormal in nerve roots, underwent symptomatic treatments, such as rehydration and hormone, and the abnormalities disappeared 3 days after treatment. There were no significant significances in operative time and intraoperative fluoroscopy times between groups I and R (p > 0.05), but there was a higher tendency in group I. The VAS scores of post-operation were significantly lower than that of pre-operation in the two groups (p < 0.05), but there were no significant differences between the two groups (p > 0.05). The MacNab score of the last follow-up showed excellent rate (95%) and good rate (90%) in groups I and R, respectively. CONCLUSIONS: Bone puncture-combined transiliac approach to intervertebral endoscopic surgery could locate iliac puncture point individually, and establish a good iliac channel, which is safe, effective, and minimally invasive.