CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(03): 474-479
DOI: 10.1055/s-0042-1751012
Original Article

Surgical Outcomes of Full-Endoscopic Lumbar Discectomy in the Early Adoption Phase

Ryoji Imoto
1   Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
,
Michiari Umakoshi
1   Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
,
Masatoshi Yunoki
1   Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
,
Masaki Tatano
1   Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
,
Koji Hirashita
1   Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
,
Kimihiro Yoshino
1   Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
,
Yasuhiko Nishimura
2   Department of Neurosurgery, Koyo Hospital, Wakayama, Japan
› Author Affiliations

Abstract

Background We adopted full-endoscopic lumbar discectomy (FELD) in 2019 with the assistance of the Japanese Society for Minimally Invasive and Endoscopic Techniques of Spinal Neurosurgery (JASMETS). This study analyzed short-term outcomes in our initial FELD cases and compared them with microdiscectomy cases performed during the same period.

Methods FELD was performed in 21 patients over a period of 2 years and 6 months (15 men and 6 women; mean age, 57.0±17.0 years). The transforaminal approach was performed in 8 patients, the posterolateral approach in 3, and the interlaminar approach in 10. During the same period, microdiscectomy was performed in 30 patients. Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores, operation time, blood loss volume, complications, and incidence of lumbar disc herniation recurrence were compared between the groups.

Results Preoperative VAS and JOA scores did not significantly differ between the FELD and microdiscectomy groups. JOA and VAS scores significantly improved in both groups after surgery. Operation time and incidence of recurrence rate did not differ.

Conclusion Spine surgeons who adopt FELD can achieve good surgical outcomes similar to those of microdiscectomy, even in the early period. Participation in JASMETS seminars and training and proctoring by a certified endoscopic spine surgeon were instrumental in our experience.



Publication History

Article published online:
01 September 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Ahn Y, Oh HK, Kim H, Lee SH, Lee HN. Percutaneous endoscopic lumbar foraminotomy: an advanced surgical technique and clinical outcomes. Neurosurgery 2014; 75 (02) 124-133 , discussion 132–133
  • 2 Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine 2008; 33 (09) 931-939
  • 3 Lee DY, Lee SH. Learning curve for percutaneous endoscopic lumbar discectomy. Neurol Med Chir (Tokyo) 2008; 48 (09) 383-388 , discussion 388–389
  • 4 Kim K, Sasaki M, Kawamoto T, Koyanagi I. Guidelines for the assessment of neurological state in spine and spinal cord disorders - scoring system for clinical studies. Spinal Surg 2016; 30: 41-52
  • 5 Arts MP, Brand R, van den Akker ME, Koes BW, Bartels RH, Peul WC. Leiden-The Hague Spine Intervention Prognostic Study Group (SIPS). Tubular diskectomy vs conventional microdiskectomy for sciatica: a randomized controlled trial. JAMA 2009; 302 (02) 149-158
  • 6 Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine 2002; 27 (07) 722-731
  • 7 Ohara Y, Mizuno J, Nishimura Y. Percutaneous endoscopic lumbar discectomy: comprehending the present and proceeding towards the future. Spinal Surg 2016; 30: 152-158
  • 8 Wang H, Zhou Y, Li C, Liu J, Xiang L. Risk factors for failure of single-level percutaneous endoscopic lumbar discectomy. J Neurosurg Spine 2015; 23 (03) 320-325
  • 9 Kong M, Xu D, Gao C. et al. Risk factors for recurrent L4-5 disc herniation after percutaneous endoscopic transforaminal discectomy: a retrospective analysis of 654 cases. Risk Manag Healthc Policy 2020; 13: 3051-3065
  • 10 Jang JS, An SH, Lee SH. Transforaminal percutaneous endoscopic discectomy in the treatment of foraminal and extraforaminal lumbar disc herniations. J Spinal Disord Tech 2006; 19 (05) 338-343
  • 11 Sairyo K, Matsuura T, Higashino K. et al. Surgery related complications in percutaneous endoscopic lumbar discectomy under local anesthesia. J Med Invest 2014; 61 (3-4): 264-269
  • 12 Tezuka F, Sakai T, Nishisho T. et al. Variations in arterial supply to the lower lumbar spine. Eur Spine J 2016; 25 (12) 4181-4187
  • 13 Dezawa A, Yunokawa S, Hirota K, Dezawa T. Surgical technique of endoscopic decompression for spinal canal stenosis using DPEL scope. Spine & Spinal Cord 2021; 107-114