Related Experiment Video
Updated: Jul 15, 2026
Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
[Surgical treatment of lumbar disc herniation]
1Schön Klinik München Harlaching, Wirbelsäulenzentrum, Akademisches Lehrkrankenhaus und Institut für Wirbelsäulenforschung der Paracelsus Medizinischen Privatuniversität Salzburg (PMU), Österreich, Harlachinger Str. 51, 81547, München, Deutschland. FHeider@Schoen-Kliniken.de.
Objective:
Herniated disc tissue removal to decompress the spinal nerve/cauda equina. Minimization of iatrogenic trauma and associated injuries.
Indications:
Conservative treatment did not sufficiently improve clinical symptoms. This is true for progressive or persisting neurological deficits, as well as for persisting pain which alters the quality of the patient`s life. Results of surgery are strongly dependent on the preoperative duration of symptoms. Paramount is the "timing" of surgery: poorer surgical results associated with increasing preoperative duration of symptoms.
Contraindications:
Conservative treatment modalities have not been exhausted.
Surgical Techniques:
There are 2 technologies (endoscopic/microsurgical) and 5 different approach strategies (endoscopic: interlaminar, transforaminal; microsurgical: interlaminar, translaminar, extraforaminal), whereby the choice is determined by morphology and location of the herniated disc. All techniques are minimally invasive and lead to comparable clinical results.
Postoperative Management:
For all techniques, patients are mobilized early. Light sports activities allowed after 2 weeks and return to work after about 4 weeks.
Results:
Good clinical outcomes in meta-analyses/large case series are between 80-95 %.
