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Journal of Neurosurgical Sciences 2020 February;64(1):16-24

DOI: 10.23736/S0390-5616.16.03658-4


language: English

Full-endoscopic interlaminar operations in lumbar compressive lesions surgery: prospective study of 350 patients - “ENDOS” Study

Marko MARKOVIĆ 1 , Nenad ŽIVKOVIĆ 1, Spaić MILAN 1, Anđela GAVRILOVIĆ 2, Dragoš STOJANOVIĆ 3, Vuk ALEKSIĆ 1, Sebastian RUETTEN 4

1 Department of Neurosurgery, Clinical Hospital Center Zemun, Belgrade, Serbia; 2 Department of Neurology, Clinical Hospital Center Zvezdara, Belgrade, Serbia; 3 Department of Abdominal Surgery, Clinical Hospital Center Zemun, Belgrade, Serbia; 4 Center for Spine Surgery and Pain Therapy, Center for Orthopedics and Traumatology of the St. Elisabeth Group, Catholic Hospital Rhein-Ruhr, St. Anna Hospital Herne/Marien Hospital Herne University Hospital/Marien Hospital Witten, Witten, Germany


BACKGROUND: Full-endoscopic operations of lumbar spine are truly minimally invasive surgical procedures. Endoscopic techniques have become the standard in many areas because of the advantages they offer intraoperatively and after surgery. With the interlaminar and transforaminal approach, two full-endoscopic procedures are available for lumbar compressive lesion operations. Our aim was to present and explain all aspects of the full-endoscopic operative technique, and presentation of results of lumbar discectomies and monosegmental decompression in full-endoscopic interlaminar technique performed during 3-year period in comparison with conventional microsurgical operations reported in literature.
METHODS: A series of 350 patients underwent full-endoscopic interlaminar lumbar discectomy, and spinal canal decompression, during a 3-year period, is analyzed. In addition to general and specific parameters, VAS and ODI scale are used as measuring instruments.
RESULTS: In our clinical series of full-endoscopic operations 88% of the patients no longer had leg pain postoperatively, and 7% had only occasional pain. In 7 (2%) patients minor nerve damage resulted in transient paresthesias, and in 2 patients resulted in neurological deficit. Dural tear occurred in 8 (2.3%) patients, and only 1 had reoperation for direct dural repair. The recurrence rate was 5.7% (3.7% had reoperation). Resection of the herniated disc and sufficient decompression was technically possible in all cases.
CONCLUSIONS: The clinical results of the full-endoscopic technique are at least equal to those of the conventional microsurgical discectomy with advantages such as reduced tissue trauma, improved patient mobility, and lower overall complication rate. With the possibility of selecting the most adequate approach, lumbar disc herniations inside and outside the spinal canal, can be sufficiently removed using the full-endoscopic technique, when taking the appropriate indication criteria into account.

KEY WORDS: Diskectomy; Endoscopy; Decompression

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