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Updated: May 31, 2025
A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
Retrospective Evaluation of Radiological and Clinical Postoperative Findings of Patients Who Had Endoscopic Lumbar
Osman Boyali1, Gulseli Berivan Sezen, Furkan Diren
1University of Health Sciences Gaziosmanpasa Training and Research Hospital, Department of Neurosurgery, Istanbul, Türkiye.
Aim:
To evaluate the postoperative magnetic resonance imaging (MRI) findings and clinical outcomes of patients who underwent monoportal endoscopic lumbar discectomy.
Material And Methods:
Preoperative and postoperative 3rd and 6th month MRI features, visual analog scale (VAS), and Oswestry Disability Index (ODI) scores, as well as other clinical features of patients who underwent monoportal endoscopic lumbar discectomy between August 2009 and January 2012 were retrospectively analyzed.
Results:
A total of 65 patients (37 female, 28 male) were included in the study. VAS and ODI scores showed significant improvement postoperatively (p < 0.001). Intervertebral disc height loss was observed only in two patients. In 31 (48%) of the 64 levels treated, no significant anterior soft tissue mass developed. However, 33 patients (52%) showed anterior epidural edema and tissue formation postoperatively. Contrast enhancement of the nerve root was found in 20 levels (29.4%), nerve root edema in 3 levels (4.41%), and nerve root displacement in 3 levels (4.41%). None of the patients had all 3 aforementioned findings concomitantly. Of the 57 levels evaluated, 36 levels (63%) showed no or minimal changes in the posterior elements, and at the 3rd month, 9 levels (15.8%) demonstrated grade 1+ changes, 9 levels showed grade 2+ changes, and grade 3+ changes were seen in only 3 levels; however, at 6-month follow-up, all vertebral levels showed improvements.
Conclusion:
Endoscopic discectomy is a safe and effective minimally-invasive method. However, owing to the lack of definitive radiological criteria indicating success or failure, the radiological findings should always be interpreted in conjunction with clinical outcomes.
Insights
Monoportal endoscopic lumbar discectomy is a safe and effective minimally invasive procedure. Postoperative MRI findings should be interpreted alongside clinical outcomes for accurate patient assessment.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
- Radiology
Background:
- Monoportal endoscopic lumbar discectomy offers a minimally invasive approach for treating lumbar disc herniation.
- Evaluating postoperative imaging and clinical outcomes is crucial for understanding the efficacy of this technique.
Purpose of the Study:
- To assess postoperative magnetic resonance imaging (MRI) findings.
- To correlate imaging results with clinical outcomes in patients undergoing monoportal endoscopic lumbar discectomy.
Main Methods:
- Retrospective analysis of 65 patients who underwent monoportal endoscopic lumbar discectomy.
- Evaluation of preoperative and 3rd/6th month postoperative MRI scans.
- Assessment of visual analog scale (VAS) and Oswestry Disability Index (ODI) scores.
Main Results:
- Significant improvements in VAS and ODI scores were observed postoperatively (p < 0.001).
- Postoperative MRI revealed anterior epidural edema and tissue formation in 52% of treated levels.
- Nerve root abnormalities (enhancement, edema, displacement) were noted in varying percentages, with no concomitant findings.
Conclusions:
- Monoportal endoscopic discectomy is a safe and effective minimally invasive surgical option.
- Radiological findings alone are insufficient; interpretation must be combined with clinical outcomes to determine success.
