A Narrative Review of Full-Endoscopic Lumbar Discectomy Using Interlaminar Approach

Lumbar disc herniation (LDH) is a frequently encountered pathologic condition in orthopedic daily practice. Discectomy is considered when patients with LDH experience persistent limb or lumbar pain or neurologic deficits. Various minimally invasive techniques are available for discectomy. Among thes...

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Bibliographic Details
Published in:World neurosurgery 2022-12, Vol.168, p.324-332
Main Authors: Fukuhara, Daisuke, Ono, Koichiro, Kenji, Takahashi, Majima, Tokifumi
Format: Article
Language:English
Subjects:
Diskectomy - methods
Diskectomy, Percutaneous - methods
Endoscopy - methods
Full-endoscopic lumbar discectomy
Full-endoscopic spine surgery
Humans
IL approach
Interlaminar approach
Intervertebral Disc Displacement - surgery
Lumbar disc herniation
Lumbar Vertebrae - surgery
Minimally invasive spinal surgery
Narrative review
PED
Percutaneous endoscopic lumbar discectomy
Retrospective Studies
Treatment Outcome
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Description
Summary:Lumbar disc herniation (LDH) is a frequently encountered pathologic condition in orthopedic daily practice. Discectomy is considered when patients with LDH experience persistent limb or lumbar pain or neurologic deficits. Various minimally invasive techniques are available for discectomy. Among these techniques, full-endoscopic lumbar discectomy (FED) is one of the least invasive options. During FED, removal of LDH is accomplished using 2 major approaches: transforaminal (TF) or interlaminar (IL). The prototype FED was percutaneous nucelotomy. An endoscope was integrated to percutaneous nucelotomy and TF endoscopic lumbar discectomy (TELD) was first derived. IL endoscopic lumbar discectomy (IELD) was introduced years after TELD. TELD and IELD can compensate for the shortcomings of each other and endoscopic spine surgeons need to acquire both techniques to deal with all type of LDHs. Because of its long history, the TF approach seems to represent the major approach for FED, but the IL approach has numerous benefits in particular types of LDH. The present article focuses on IELD and reviews the history, surgical techniques, indications and contraindications, clinical outcomes, and complications. This review will contribute to improved understanding of IELD as an important technique in full-endoscopic spine surgery.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2022.08.080