[The lumbar disc herniation - management, clinical aspects and current recommendations]
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Updated: May 27, 2026

Full Endoscopic Interlaminar Approach for Paracentral L5-S1 Disc Herniation
Published on: April 14, 2023
M N Stienen1, D Cadosch, G Hildebrandt
1Klinik für Neurochirurgie, Kantonsspital St. Gallen. martin.stienen@kssg.ch
Abstract:
Lumbar disc herniation has a high prevalence and strong social-medical impact. Patients suffer from lower back pain that radiates from the spine. Loss of sensation or paresis adds to the clinical picture. The diagnosis should be confirmed by imaging in patients considered for surgery. High remission rates initially warrant conservative treatment (adequate analgesia and physiotherapy) in many patients. If this treatment does not lead to significant alleviation within 5-8 weeks, surgery should be performed to reduce the risk of chronic nerve affection. Posterior interlaminar fenestration is the intervention primarily conducted for this diagnosis. A relapse in the same region occurs in up to 10% of patients after months through years, which sometimes necessitates a reoperation if symptoms are pertinent.
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