Percutaneous Endoscopic Lumbar Discectomy for the Treatment of Far Lateral Lumbar Disc Herniation

ABSTRACT

OBJECTIVE: There are few reports on the clinical outcomes of the percutaneous endoscopic lumbar discectomy(PELD) with laser for the treatment of far lateral lumbar disc herniation. The objective of this study is to assess the safety and efficacy of the PELD with laser for the treatment of far lateral lumbar disc herniation. METHODS: The clinical records of 42 patients who had far lateral lumbar disc herniation and underwent PELD with laser between January 1996 and August 2002 were analyzed retrospectively. There were 24(57.1%) males and 18(42.9%) females, with a mean age of 53(range, 26-73) years. The surgical procedure was performed via a posterolateral approach after induction of a local anesthesis. The clinical outcomes were measured with MacNabO s criteria. The mean follow-up period was 38(range, 5-77) months. RESULTS: Clinical outcomes were revealed as follows excellent in 28 patients(66.7%); good in 11(26.2%); fair in 2(4.7%); and poor in 1(2.4%). Therefore, the percentage of successful(excellent and good) outcomes was 92.9%. There was no statistically significant variation in the success rates according to age and operation level(p>0.05). Before the introduction of the high resolution endoscope, the success rate was 90.3% but after upgrading to the high resolution endoscope, the success rate was 100%, and there was a statistically significant variation in the success rate(p<0.05). In all cases, there was no complication or recurrence. CONCLUSION: As a minimally invasive surgery, PELD with laser is a safe and efficacious procedure for the treatment of far lateral disc herniation.