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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...

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Related Experiment Video

Updated: Jul 3, 2026

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
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Full-Endoscopic Surgery for Lumbar Disc Herniation: Comparative Outcomes and Risk Factors Between Lumbar Levels-The

Justine Bidard1, Marc Szadkowski2,3, Nori Elhadjene4

  • 1Department of Neurosurgery, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France.

International Journal of Spine Surgery
|March 30, 2026
PubMed
Summary
This summary is machine-generated.

Full-endoscopic lumbar discectomy (FELD) effectively treats upper lumbar disc herniation (ULDH), yielding outcomes comparable to lower lumbar disc herniation (LLDH). This minimally invasive approach offers significant pain relief and functional improvement for ULDH patients.

Keywords:
full endoscopylower lumbar disc herniationlumbar discectomyspine surgeryupper lumbar disc herniation

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Area of Science:

  • Minimally invasive spine surgery
  • Lumbar spine anatomy and pathology
  • Endoscopic surgical techniques

Background:

  • Upper lumbar disc herniation (ULDH) is rare, complex, and presents unique challenges.
  • Limited data exists on the efficacy of full-endoscopic lumbar discectomy (FELD) for ULDH.
  • ULDH often affects older patients and requires specialized surgical approaches due to narrower spinal canals.

Purpose of the Study:

  • To compare clinical outcomes of FELD between ULDH and lower lumbar disc herniation (LLDH).
  • To identify risk factors specific to ULDH.
  • To describe perioperative differences between ULDH and LLDH patient groups.

Main Methods:

  • Retrospective analysis of 806 patients undergoing FELD for lumbar disc herniation (LDH).
  • Patients stratified into ULDH (L1-L4 levels) and LLDH (L4-S1 levels) groups.
  • Comparison of demographic, operative, and clinical outcomes including pain scores, disability indices, complications, and reoperation rates.

Main Results:

  • ULDH patients were significantly older (57.3 vs 46.0 years) and had higher rates of persistent neurological deficits (36.0% vs 25.6%).
  • Despite longer operative times and anatomical challenges in ULDH, both groups achieved similar significant reductions in pain and comparable improvements in Oswestry Disability Index scores.
  • Patient satisfaction rates were high (>90%) in both ULDH and LLDH groups.

Conclusions:

  • FELD is an effective and well-tolerated treatment for ULDH, providing outcomes comparable to LLDH.
  • The findings support the expanded use of FELD for all lumbar levels, emphasizing careful surgical planning.
  • Further prospective studies are warranted to validate these findings and explore long-term outcomes.