Outcomes of percutaneous endoscopic lumbar discectomy via a translaminar approach, especially for soft, highly down-migrated lumbar disc herniation.

PURPOSE: This study reports a new approach for percutaneous endoscopic lumbar iscectomy (PELD), especially for soft, highly down-migrated lumbar disc herniation.

METHODS: Seven patients with soft, highly down-migrated lumbar disc herniation who underwent PELD via a translaminar approach under local anaesthesia from January 2013 to June 2015, including five patients who underwent failed PELD in other hospitals, were retrospectively analyzed. Clinical outcomes were evaluated according to pre-operative and post-operative visual analogue scale (VAS) scores, Oswestry disability index (ODI) scores and post-operative magnetic resonance imaging (MRI).

RESULTS: The highly down-migrated lumbar disc herniation was completely removed by PELD via a translaminar approach in seven patients, as confirmed by post-operative MRI. Leg pain was eased after removal of the disc migrations. The mean follow-up duration was 9.8 (range, 6-14) months. The mean pre-operative VAS was 7.6 ± 0.8 (range, 6-9), which decreased to 3.1 ± 1.5 (range, 2-5) at one week post-operatively and to 1.3 ± 0.8 (range, 0-3) by the last follow-up visit. The mean pre-operative ODI was 61.6 (range, 46-84), which decreased to 16.3 (range, 10-28) at the one month post-operative follow-up and to 8.4 (range, 0-14) by the last follow-up visit. No recurrence was observed in any of the seven patients during the follow-up period.

CONCLUSION: PELD via a translaminar approach could be a good alternative option for the treatment of soft, highly down-migrated lumbar disc herniation.