Percutaneous endoscopic interlaminar discectomy for intracanalicular disc herniations at L5-S1 using a rigid working channel endoscope.

摘要: Objective Percutaneous endoscopic transforaminal discectomy is often used as a minimally invasive procedure for lumbar disc herniation. However, approach posts limitations at the L5-S1 level owing to anatomic constraints, such high iliac crest or small intervertebral foramen and especially migrated large intracanalicular herniations. We discuss clinical results of percutaneous interlaminar using rigid working channel endoscope relevant surgical anatomy. Methods performed through in 67 patients who satisfied our inclusion criteria during period from March 2002 November 2002. All procedures were under local anesthesia. Under fluoroscopic guidance, we discography indigocarmine mixed with radio-opaque dye. The 6-mm was then introduced into epidural space. Herniated material removed forceps laser clear visualization. retrospectively evaluated 65 cases more than 1.5 years follow-up. visual analogue scale (VAS) Oswestry Disability Index (ODI). Results VAS leg pain (preoperative mean, 7.89; postoperative 1.58) ODI 57.43; 11.52) showed statistically significant (P = 0.00) improvement their values last follow-up examination compared preoperative scores. Of study group, 90.8% individuals favorable result. mean hospital stay 12 hours. average time return work 6.79 weeks. Complications included two dural injury cerebrospinal fluid leakage, nine dysesthesia that transient, one case recurrence. Two required conversion open initial operation. There no evidence infection any patients. Conclusion safe, effective, treatment herniations properly selected cases, when not possible because constraints.