M Srinivasan*

Consultant Orthopedic Surgeon, Srinivasa Hospitals, Nagercoil, India

*Corresponding Author: M Srinivasan, Consultant Orthopedic Surgeon, Srinivasa Hospitals, Nagercoil, India.

Received: September 21, 2022; Published: October 07, 2022

Abstract

Introduction: Posterior endoscopic discectomy is a time proven technique for the management of lumbar disc prolapse. Many endoscopic systems are being used for this technique. We report a study of first 50 patients operated by this endoscopic system (Destandau) in our centre. It is proved to be a safe technique and has a better learning curve.

Materials and Methods: A total of 50 patients suffering from lumbar disc herniation were operated from Jan 2017 to Dec 2019. Patients requiring two level surgeries and associated lumbar canal stenosis were excluded from this study. Endoscopic discectomy was done through the endospine system, using a 15 mm incision. The results were evaluated using the modified Macnab’s criteria. The average follow up period was 24 months.

Results: 80% patients had excellent results and 20% patients had good results. None of them had fair or poor results. The complications observed were minor dural tear in two patients, nerve root injury in one patient, facetal damage in one patient. 80% of patients were able to return to light work in 2 weeks time and normal physical activities in 6 weeks time.

Conclusion: Posterior endoscopic discectomy is a safe and proven method of treating lumbar disc herniation. It allows early mobilization of patients and return to work. The technique is proved to have a better learning curve and familiar instrumentation for the conventional spine surgeon.

Keywords: Endoscopic Discectomy; Endospine; Lumbar Disc Prolapse; Minimally Invasive Spine; Destandau Technique

References

1. Caspar W. “A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach”. Advances in Neurosurgery 4 (1977): 74-80.
2. Yorimitsu E., et al. “Long term outcomes of standard discectomy for lumbar disc herniation: A follow up study of more than 10 years”. Spine (Phila Pa 1976) 26 (2001): 652-657.
3. Gibson JN and Waddell G. “Surgical interventions for Lumbar disc prolapse”. Cochrane Database System Review (2007): CD001350.
4. Imhof HG., et al. “Use of the microscope in surgery of the lumbar disc hernia”. Aktuelle Probleme in Chirurgie und Orthopädie 44 (1994): 15-20.
5. Yasagril MG and Krayenbuhl H. “The use of binocular microscope in Neurosurgery”. Bibl Ophthalmology 81 (1970): 62-65.
6. Findlay GF., et al. “A10 year follow up of the outcome of lumbar microdiscectomy”. Spine 23 (1998): 1168-1171.
7. Maroon JC. “Current concepts in minimal invasive discectomy”. Neurosurgery 51 (2002): S137-145.
8. Katayama Y., et al. “Comparison of surgical outcomes between macro discectomy and microdiscectomy for lumbar disc herniation. A prospective randomized study with surgery performed by same surgeon”. Journal of Spinal Disorders and Techniques 19 (2006): 344-347.
9. Faubert C and Caspar W. “Lumbar percutaneous discectomy. Initial experience in 28 cases”. Neuroradiology 33 (1991): 407-410.
10. Mayer HM and Brock M. “Percutaneous endoscopic discectomy: Surgical technique and preliminary results compared to microsurgical disccetomy”. Journal of Neurosurgery 78 (1993): 216-225.
11. Shin DA., et al. “The efficacy of microendoscopic discectomy in reducing iatrogenic muscle injury”. Journal of Neurosurgery Spine 8 (2008): 39-43
12. Destandau J. “Endoscopically-assisted treatment of lumbar disc prolapse - Endoscopic microdiscectomy”. Cabinet de Neurochirutgie de 1 (2002): 4-13
13. Kaushal M and Sen R. “Posterior endoscopic discectomy: Results in 300 patients”. Indian Journal of Orthopaedics 46 (2012): 81-85.
14. Ranjan A and Lath R. “Microendoscopic discectomy for prolapsed lumbar intervertebral disc”. Neurology India 54 (2006): 190-194.
15. Rohidas SM and Destandau J. “Endoscopic spine surgery”. Thieme Publication (2017): 29.
16. Williams RW. “Microlumbar discectomy: A conservative approach to virgin herniated lumbar disc”. Spine 3 (1978): 175-182.
17. Caspar W. “A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach”. Advances in Neurosurgery 4 (1977): 74-80.
18. Paresh Chandra Dey and Saurav Narayan Nanda. “Functional Outcome after Endoscopic Lumbar Discectomy by Destandau’s Technique: A Prospective Study of 614 Patients”. Asian Spine Journal (2019): 5.
19. Muramatsu K., et al. “Post operative MRI of lumbar disc herniation; Comparison of microendoscopic discectomy and Love's method”. Spine (Phila Pa 1976) 26 (2001): 1599-1605.
20. Schick U., et al. “Microendoscopic lumbar disccetomy versus open surgery; An interaoperative EMG study”. European Spine Journal 11 (2002): 20-26.
21. Sasaoka R., et al. “Objective assessment of reduced invasiveness in MED: Compared with one level laminotomy”. European Spine Journal 15 (2006): 577-582.
22. Foley KT., et al. “Microendoscopic approach to far lateral lumbar disc herniation”. Neurosurgery Focus 7 (1999): 5.
23. Issacs RE., et al. “Microendoscopic disccetomy for recurrent disc herniations”. Neurosurgery Focus 15 (2003): 11.
24. Jhala A and Mistry M. “Endoscopic lumbar disccetomy; Experience of first 100 cases”. Indian Journal of Orthopaedics 44 (2010): 184-190.

Citation

Citation: M Srinivasan. “Interlaminar Endoscopic Lumbar Discectomy - Results in First 50 Patients". Acta Scientific Orthopaedics 5.11 (2022): 34-38.

Copyright

Copyright: © 2022 M Srinivasan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.