THE RESULTS AND COMPLICATIONS OF INTERLAMINAR ENDOSCOPIC APPROACH FOR LUMBAR DISC HERNIATION: AN OVERVIEW OF A SINGLE-SURGEON EXPERIENCE

Objective: Interlaminar endoscopic approach has become a main operative option for lumbar disc herniations over the past decade.This method stands out for not only successful pain management but also for low complication rate, as shown in many studies.We aimed to present the results of a single senior surgeon with long-term follow-up.Materials and Methods: The interlaminar approach was executed to 142 patients with lumbar disc herniation.In total, 151 disc herniations were performed.Motor deficit and intractable radicular pain were considered indication for interlaminar endoscopic lumbar discectomy (IELD), similar to open microdiscectomy.Cauda equina syndrome and vertebral instability deemed as contraindications.Results: All patients had severe radicular pain.One hundred and thirty-two patients (92.9%) exhibited positive nerve stretch results, and 67 (47.2%) patients had motor deficit.Ten patients had a history of prior lumbar surgery.L4-L5 (33.1%) and L5-S1 levels (59.2%) were the most frequently operated levels.Nine patients (6.3%) underwent IELD for multiple level.Complications were noted in six patients (4.2%) during hospitalization.Dural tear occured in four patients (2.8%) and motor deficit was observed in one patient (0.7%).No repair surgery was required for dural tear.The mean follow-up duration was 9.1 years.Nine patients (6.3%) had recurrent disc herniation.The mean duration of recurrence was 20.9 months, and 77.8% of recurrences occurred in the first year.One patient underwent posterior stabilization 1 year after the last surgery.No infection or spondylodiscitis was experienced in our cases. Conclusion:The results of a single experienced senior surgeon indicated that IELD was a highly safe method.This method is on course to become a common method for treating many lumbar spine disorders as technological advancements in endoscopic tools and the increase in patient experience.