Skip to main content

Advertisement

SpringerLink
Log in

Full-endoscopic lumbar discectomy via lateral superior articular process approach for treating far lateral lumbar disc herniation: a retrospective study and technical note

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

This study aims to evaluate the efficacy and safety of the full-endoscopic lumbar discectomy (FELD) via lateral superior articular process (LSAP) approach and full-endoscopic transforaminal discectomy (FETD) for treating far lateral lumbar disk herniation (FFLDH).

Methods

From January 2020 to June 2022, patients who were diagnosed as FLLDH underwent the FELD via LSAP approach or FETD. The operation time, estimated blood loss, length of hospital stays, and complications were recorded. The visual analog scale (VAS) for back pain, VAS for leg pain, and the Oswestry Disability Index (ODI) scores was measured during preoperative and postoperative follow-up.

Results

Thirty-two patients were enrolled in this study, of which 12 patients were treated with the FELD via LSAP approach (LSAP-FELD group) and 20 patients underwent FETD (FETD group). The LSAP-FELD group exhibited significantly shorter operation times and hospital stays compared to the FETD group, while no statistically significant differences were observed in intraoperative blood loss and complication rates. There were no significant differences in the VAS for back pain, the VAS for leg pain, and the ODI score between the two groups preoperatively and three days, three months, and the last follow-up postoperatively.

Conclusions

Both the FELD via LSAP approach and FETD have demonstrated favourable clinical efficacy in the treatment of FLLDH. Notably, the FELD via LSAP approach shows the advantages of shorter operation time and hospital stays.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability

The raw data supporting the conclusions of this article will be made available by the authors.

References

  1. Abdullah AF, Ditto ER, Byrd EB, Williams R (1974) Extreme-lateral lumbar disc herniations. Clinical syndrome and special problems of diagnosis. J Neurosurg 41(2):229–234. https://doi.org/10.3171/jns.1974.41.2.0229

    Article  CAS  PubMed  Google Scholar 

  2. Epstein NE (2002) Foraminal and far lateral lumbar disc herniations: surgical alternatives and outcome measures. Spinal Cord 40(10):491–500. https://doi.org/10.1038/sj.sc.3101319

    Article  CAS  PubMed  Google Scholar 

  3. Yeung AT, Tsou PM (2002) Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976) 27(7):722–731. https://doi.org/10.1097/00007632-200204010-00009

    Article  PubMed  Google Scholar 

  4. Hoogland T, Schubert M, Miklitz B, Ramirez A (2006) Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine (Phila Pa 1976) 31(24):E890–E897. https://doi.org/10.1097/01.brs.0000245955.22358.3a

    Article  PubMed  Google Scholar 

  5. Zheng C, Wu F, Cai L (2016) Transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral lumbar disc herniations in children. Int Orthop 40(6):1099–1102. https://doi.org/10.1007/s00264-016-3155-x

    Article  PubMed  Google Scholar 

  6. Uchikado H, Nishimura Y, Hattori G, Ohara Y (2020) Micro-anatomical structures of the lumbar intervertebral foramen for full-endoscopic spine surgery: review of the literatures. J Spine Surg 6(2):405–414. https://doi.org/10.21037/jss.2019.10.07

    Article  PubMed  PubMed Central  Google Scholar 

  7. Montinaro A (2004) The microsurgical approach to extraforaminal lumbar disc herniations. An analysis of 15 cases. J Neurosurg Sci 48(1):23–28

    CAS  PubMed  Google Scholar 

  8. Zhou Y, Zhang C, Wang J, Chu TW, Li CQ, Zhang ZF, Zheng WJ (2008) Minimally invasive strategies and options for far-lateral lumbar disc herniation. Chin J Traumatol 11(5):259–266. https://doi.org/10.1016/s1008-1275(08)60053-x

    Article  PubMed  Google Scholar 

  9. Zhang Y, Pan Z, Yu Y, Zhang D, Ha Y, Yi S, Shin DA, Sun J, Koga H, Phan K, Azimi P, Huang W, Cao K (2018) The modified transforaminal endoscopic technique in treating intracanalicular combining foraminal and/or extraforaminal lumbar disc herniations. Quant Imaging Med Surg 8(9):936–945. https://doi.org/10.21037/qims.2018.10.02

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zhu Y, Huang R, Tao X, Xu X (2021) Short-term efficacy of percutaneous transforaminal endoscopic BEIS technique for L4 /5 far lateral lumbar disc herniation. J Minim Invasive Med 16(05):630–633. https://doi.org/10.11864/j.issn.1673.2021.05.08

    Article  Google Scholar 

  11. Chang H, Xu J, Yang D, Sun J, Gao X, Ding W (2023) Comparison of full-endoscopic foraminoplasty and lumbar discectomy (FEFLD), unilateral biportal endoscopic (UBE) discectomy, and microdiscectomy (MD) for symptomatic lumbar disc herniation. Eur Spine J 32(2):542–554. https://doi.org/10.1007/s00586-022-07510-6

    Article  PubMed  Google Scholar 

  12. Park JH, Jung JT, Lee SJ (2018) How I do It: L5/S1 foraminal stenosis and far-lateral lumbar disc herniation with unilateral bi-portal endoscopy. Acta Neurochir (Wien) 160(10):1899–1903. https://doi.org/10.1007/s00701-018-3630-9

    Article  PubMed  Google Scholar 

  13. Aydın AL, Sasani M, Sasani H, Üçer M, Hekimoğlu M, Öktenoğlu T, Özer AF (2020) Comparison of two minimally invasive techniques with endoscopy and microscopy for extraforaminal disc herniations. World Neurosurg 144:e612–e621. https://doi.org/10.1016/j.wneu.2020.09.022

    Article  PubMed  Google Scholar 

Download references

Funding

Project Supported by Scientific and Technological Research Program of Chongqing Municipal Education Commission (Grant No. KJQN202200425).

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, No.76, Linjiang Road, Yuzhong District, Chongqing, 400010, China

    Lu Lin, Zhen-Yong Ke, Lei Chu, Yun Cheng, Guo-Sheng Zhao, Dian Zhong, Xin Cai & Xiao-Lin Chen

  2. Pain Medical Center, The Second Affiliated Hospital of Chongqing Medical University, No.76, Linjiang Road, Yuzhong District, Chongqing, 400010, China

    Lu Lin & Lei Chu

Authors
  1. Lu Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhen-Yong Ke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lei Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yun Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Guo-Sheng Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dian Zhong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xin Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xiao-Lin Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and design: Xiao-Lin Chen, Zhen-Yong Ke, and Lu Lin; collection of the clinical data: Lu Lin and Lei Chu; statistical analysis: Yun Cheng and Guo-Sheng Zhao; investigation and the relevant literature review: Dian Zhong and Xin Cai; manuscript writing: Lu Lin and Xiao-Lin Chen; revision of the paper: Xiao-Lin Chen. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Xiao-Lin Chen.

Ethics declarations

Ethical approval

This study involving human participants was reviewed and approved by the Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University.

Consent for publication

All authors agreed to publish the paper.

Informed consent

All patients signed the informed consent form before study inclusion.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, L., Ke, ZY., Chu, L. et al. Full-endoscopic lumbar discectomy via lateral superior articular process approach for treating far lateral lumbar disc herniation: a retrospective study and technical note. International Orthopaedics (SICOT) 47, 2843–2850 (2023). https://doi.org/10.1007/s00264-023-05937-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-023-05937-0

Keywords

Search

Navigation