Abstract

Introduction:Full-endoscopic operation of lumbar disc herniations in transforaminal and interlaminar technique enables sufficient decompression. This technique can offer advantages over standard operations and can be an alternative to the microsurgical technique. Objective of this prospective study was to compare the outcome of full-endoscopic (Group 1) with microsurgical (Group 2) decompression in lumbar disc herniations.Material and Methods:90 patients were operated in full-endoscopic transforaminal (19 pats.) and interlaminar (26 pats) or microsurgical (45 pats.) technique. Inclusion criteria were: singlelevel disc herniation, no central stenosis, no pronounced instabilities or deformities, unilateral leg pain, back pain max. 10/100 VAS. The full-endoscopic operation was performed under continuous irrigation with 6.9-mm endoscopes with a 4.2-mm intraendoscopic working canal. There were specific inclusion criteria for the lateral transforaminal or interlaminar access. The follow-up was 24 months and included 92% of the patients. Validated measuring instruments were used in addition to general parameters.Results:2 patients in Group 1 and 1 patient in Group 2 presented transient dysaesthesia. The mean operation time in Group 1 was 23 minutes, in Group 2 42 minutes. There was no measurable blood loss in Group 1, the mean loss in Group 2 was 55 ml. The maximum time in hospital for Group 1 patients was 4 days and 6 days in Group 2. The follow-up showed satisfactory subjective results in 87% with no significant differences between the two groups. This also corresponded to the constant results of the measuring instruments. The postoperative pain symptoms and rehabilitation were significantly reduced in Group1.Recurrence was found in 3 patients in Group1 and 2 patients in Group 2 during the postoperative observation period. Conclusion:Within the indication criteria, full-endoscopic operation of lumal disc herniations is sufficiently feasible and a potent alternative to the microsurgical procedure. It enables selective procedure with direct visualization, decompression is found to be sufficient and the rate of complications is low, traumatization of the access pathway and the vertebral canal is reduced.