The strategy and early clinical outcome of full-endoscopic L5/S1 discectomy through interlaminar approach

Consideration of proper operative route for interlaminar approach for percutaneous endoscopic lumbar discectomy

“…On the other hand, operative complications and operative techniques to prevent the complications have not yet been fully described (15)(16)(17)(18)(19). Furthermore, most of the studies focused on the transforaminal approach, and only a few reports were available regarding the ILA (11,12,(20)(21)(22). We, therefore, analyzed the results of ILA through two different operative routes: via the shoulder and via the axilla, and investigated the appropriate operative route for ILA to prevent complications.…”

“…Furthermore, ILA has two different operative routes: via the shoulder of the corresponding nerve root and via the axilla of the corresponding nerve root and dural sac (1,11,12). We do not have definitive criteria for selection of an appropriate operative route for ILA.…”

The Strategy and Early Clinical Outcome of Percutaneous Full-Endoscopic Interlaminar or Extraforaminal Approach for Treatment of Lumbar Disc Herniation

“…Nonetheless, it must be remembered that difficulties can never be ruled out during the learning progress. But some preparations are necessary, such as training in an experienced spine center, and attending the cadaveric workshops could be meaningful; and “simple” cases with big interlaminar window should be operated on to begin with, in which difficulties could not be avoided thanks to manipulation technique and the anatomic situation, if problems are encountered intraoperatively and switched to a standard procedure [1, 12, 17, 21]. …”

“…The spinal endoscopic technique is designed to protect spinal stiffness and dynamic structure as well as to reduce and avoid traditional open surgery-related complications [1, 2]. Endoscopic surgery has some advantages, including clear visualization, less damage to the paraspinal muscle and other normal tissues, good cosmetic effect, and reduced patient morbidity with early return to work [3, 4].…”

Anatomical relationship between Kambin’s triangle and exiting nerve root

“…Converting from a translaminar to an interlaminar approach is a reasonable option. In 2015, Li et al [26] evaluated the efficacy of fully endoscopic interlaminar L5-S1 discectomy in 72 patients with axillary, ventral, or shoulder types/locations of disc herniation. They used postoperative MRI to confirm the extent of resection.…”