Full-endoscopic discectomy via the interlaminar approach for disc herniation at L4-L5 and L5-S1: An observational study

The purpose of this retrospective study was to investigate the clinical outcomes of full-endoscopic discectomy via the interlaminar approach in the treatment of lumbar disc herniation (LDH) at L4-L5 under general anesthesia. Eighty-four patients who underwent full-endoscopic discectomy via the interlaminar approach at L4-L5 or L5-S1 were included. Durations of surgery, intraoperative radiation, postoperative bedrest, and hospitalization as well as perioperative complications were recorded. The visual analog scale (VAS) score for leg and back pain and the Oswestry disability index (ODI) score were evaluated preoperatively and at 3, 6, and 12 months postoperatively. The mean durations of surgeries in surgeries involving L4-L5 and L5-S1 were 69.8 ± 18.8 and 67.0 ± 20.1 minutes, respectively. The mean durations of intraoperative radiation were 1.2 ± 0.3 and 1.3 ± 0.3 seconds, respectively. The mean VAS and ODI scores improved significantly postoperatively compared with the preoperative scores. The perioperative complications included intraoperative epineurium injury in 3 cases without nerve injury, cerebrospinal fluid leakage, or cauda equina syndrome. The total recurrence rate after 12 months follow-up was 1.2% (one case at L5-S1). Full-endoscopic discectomy via the interlaminar approach could be considered as one of the alternative options for the treatment of LDH at L4-L5.