[Analysis of effectiveness of interrupt percutaneous endoscopic lumbar discectomy through interlaminar approach for...

To evaluate the effectiveness of interrupt percutaneous endoscopy lumbar discectomy (PELD) through interlaminar approach for L5, S1 disc protrusion.

Between November 2006 and August 2010, 115 patients with L5, S1 disc protrusion were treated, including 79 males and 36 females with an average age of 38 years (range, 14-79 years). All patients showed the dominated symptom of the S1 nerve root. The working channel was established by puncturing through interlaminar approach under the local anesthesia. After the needle was used to make sure no nerve root or dural sac on working face, the disc tissue was excised directly by blind sight. Then the nerve root decompression was observed through the endoscope. In patients with free type, fragment compression was observed through the endoscope, and the disc tissue around the nerve roots was removed, then the free disc tissue around intervertebral space was excised.

One patient who failed to puncture changed to miniopen discectomy; 3 patients who failed changed to post lateral approach; and the others underwent interrupt PELD through interlaminar approach. Eighty patients were followed up 18 months on average (range, 12-36 months). The average Oswestry Disability Index (ODI) was reduced to 13% +/- 5% at 12 months after operation and to 12% +/- 8% at last follow-up from 73% +/- 12% at preoperation, showing significant differences (P < 0.01). According to modified Macnab's criterion, the results were excellent in 59 cases, good in 15 cases, fair in 3 cases, and poor in 3 cases at last follow-up, and the excellent and good rate was 92.5%.

For the treatment of disc protrusion at the L5, S1 level, interrupt PELD through interlaminar approach should be ideal with short operation time, small trauma, and quick recovery.