Related Experiment Video
Updated: Dec 5, 2025
Full Endoscopic Interlaminar Approach for Paracentral L5-S1 Disc Herniation
Published on: April 14, 2023
Endoscopic L5/S1 discectomy through interlaminar approach for the patient with the high iliac crest and migrated disc
Shaohua Liu1, Hongqi Zhang2, Chunyue Duan2
1Department of Spine Surgery and Orthopaedics; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China. liushaohua509@163.com.
Objectives:
To explore the clinical efficacy of endoscopic L5/S1 discectomy through interlaminar approach for the patient with the high iliac crest and migrated disc herniation.
Methods:
A retrospective study of 31 patients with the high iliac crest and migrated disc herniation at the L5/S1 level was conducted in our hospital. All of the consented patients accepted endoscopic L5/S1 discectomy through interlaminar approach from January 2016 to January 2019. Preoperative, postoperative, and follow-up Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to assess the pain and waist function of patients. The clinical efficacy was evaluated according to Macnab criteria.
Results:
All the patients were followed up for 12-48 (29.68±9.64) months. The operation time was (79.16±22.43) min. The times of fluoroscopy were 2.71±0.78. The VAS of low back and leg pain was 7.09±0.94 before the surgery, 1.45±1.23 at 3 months after the surgery, and 1.27±0.92 at the last follow-up. The VAS after the surgery and at the last follow-up was significantly lower than that before the operation (P<0.05). The ODI was 56.03±6.64 before the surgery, 16.45±6.83 at 3 months after the surgery, and 13.03±4.96 at the last follow-up. The ODI was significantly lower after the surgery and at the last follow-up compared with that before the surgery (P<0.05). The Macnab score at the last follow-up was graded as excellent in 26 cases, good in 3 cases, fair in 2 cases, and the percentage of excellent and good were 93.5%. Part of the nucleus pulposus remained in 2 cases after the operation, one case underwent endoscopic revision and one case received conservative treatment; postoperative pain due to nerve root irritation was in one case and relieved by conservative treatment.
Conclusions:
The endoscopic L5/S1 discectomy through interlaminar approach is a relatively safe and effective treatment for the patient with the high iliac crest and migrated disc herniation, which can reduce X-ray examinations and complications, and achieve satisfactory clinical outcomes.
