Endoscopic excision of intervertebral disc herniations in the lumbar region

Česká verzia

Authors: M. Mrůzek; O. Krejčí; T. Hrbáč; R. Lipina
Authors place of work: Neurochirurgická klinika LF OU a FN Ostrava
Published in the journal: Cesk Slov Neurol N 2026; 89(2): 102-106
Category: Původní práce
doi: https://doi.org/10.48095/cccsnn2026102

Summary

Introduction: Herniated disc is a common cause of lumbar radiculopathy. Full endoscopic discectomy is a minimally invasive alternative to microdiscectomy. The aim of the study was to evaluate the results and complications of endoscopic procedures and to compare the transforaminal and interlaminar approaches. Methods: A retrospective analysis included 64 patients (40 men, 24 women; mean age 51.2 years). Transforaminal approach was performed in 12 patients and interlaminar in 52 patients. In both groups, we evaluated the duration of surgery, X-ray exposure, Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) (before the procedure, at discharge, 3 and 12 months after surgery), postoperative complications, and the frequency of postoperative recurrence of herniated disc. Results: The mean duration of surgery was 62 min. X-ray exposure was longer with the transforaminal approach (43 s) than with the interlaminar approach (22 s; P < 0.001). VAS decreased from 7.4 ± 1.2 to 1.3 ± 0.8 at 12 months (P < 0.0001), and ODI from 56% ± 13% to 14% ± 9% (P < 0.0001). No significant difference was found between the transforaminal and translaminar approaches in VAS and ODI. The results are valid for the entire group of patients. The overall complication rate was 14.0%. We recorded dural sac injuries twice (3.1%) without the need for surgical revision. Recurrence of disc herniation was recorded in 7 patients (10.9%). Conclusion: Transforaminal and translaminar endoscopic extirpation of intervertebral disc herniation is an effective and safe method with rapid recovery and low morbidity. The translaminar approach is suitable for centrolateral herniations, where it allows a more direct and anatomically clearer approach to the pathology with better control of the dural sac and nerve root and is associated with lower technical demands. The transforaminal approach is used for medial and laterally localized intervertebral disc herniations. The advantage is the preservation of the integrity of the spinal canal with minimal manipulation of the dural sac. However, it is technically more demanding and the result depends on the experience of the surgeon.

Keywords:

Endoscopic surgery – interlaminar approach – herniated intervertebral disc – transforaminal approach

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