Fully endoscopic interlaminar and transforaminal lumbar discectomy: clinical results of 857 surgically treated patients

Minimally invasive surgical techniques are becoming increasingly common in spinal surgery in an attempt to decrease tissue trauma during surgery, which in turn decreases post-operative pain and opioid use. The aim of this study was to investigate the clinical outcomes of a large group of patients with lumbar disc disease who underwent full endoscopic surgery. 857 patients who underwent fully endoscopic lumbar discectomy were investigated retrospectively. General demographics were evaluated in terms of mean operating time, mean length of hospital stay, mean time to return to work, complications and recurrences. Clinical outcomes were evaluated using visual analogue scale (VAS) for low back and leg pain, and Oswestry Disability Index (ODI) for functional assessment. The mean follow-up time was 36 months. The operation time ranged from 20 to 65 minutes (39 min on average), and there was no measurable intraoperative blood loss. Patients were mobilised on average 3.5 hours after the surgery. The length of hospital stay after the operation was 12-24 hours (18 hours on average). During postoperative follow-up, 19 patients required revision surgery due to recurrence (2.2%). There was one case of nerve root injury in which the patient recovered well following physical therapy, and 11 cases of paresthesia that gradually improved following 2-6 weeks of rehabilitation and treatment with pregabalin. All types of lumbar disc herniations are accessible via the full-endoscopic technique. Full-endoscopic discectomy, as a minimally invasive procedure, has the technical advantages of less paraspinal muscle dissection, less tissue trauma, less risk of spinal instability, and minimal blood loss.