Endoscopic Management of Lumbar Disc Prolapse

• Main Authors: Mahmoud Mahmoud, Adel Almelesy, Mostafa Alsayed Mohamed
• Format: Article
• Language: English
• Published: Egyptian knowledge bank 2021-07-01
• Series: International Journal of Medical Arts
• Subjects: lumbar disc herniation; spine endoscopic systems; interlaminar approaches; easy go; destandue systems
• Online Access: https://ijma.journals.ekb.eg/article_183894_1a2522b02482e3afcdcf7642fb7a39e9.pdf
• ISSN: 2636-4174; 2682-3780

Background: Endoscopic management of lumbar disc herniation as a minimally invasive procedure become more popular around the world. Although accepted surgical outcomes of the endoscopic approach to manage lumbar disc herniation [LDH], this procedure still to be relatively challenging and needs a high learning curve, so operative failures and complications may occur. The Aim of The Work: To assess using the endoscope in the management of lumbar disc prolapse by interlaminar approach using Easy Go and Destandau systems. Patients and Methods: This is study included twenty patients, who had lumbar disc herniation, and operated by using Easy Go and Destandau's endoscopic systems after the failure of conservative treatment. They were included between March 2016 and April 2020. They followed up for at least three months postoperatively. All were selected from the Neurosurgery Department, Al-Azhar University Hospitals, Egypt. Results: Low back pain was the main complaint reported by all patients. The radicular side was mainly the left side [70.0%] and L4/L5 was the most common affected level [65.0%]; the disc protrusion was mainly paracentral [80.0%]. There was a significant pain reduction after surgery when compared to before surgery. The outcome was excellent for 55.0%, good for 25%, fair for 15% and poor for 5%. Complications were in the form of unintended durotomy among 10.0%, nerve injury among 10.0% and infection among 5.0%.  Conclusion: Endoscopic lumbar discectomy through interlaminar approach by Destandau's and Easy Go systems become a golden procedure to manage lumbar disc prolapse at any level especially L5-S1 as a minimally invasive technique with some accepted complications that can easily be managed compared to classic traditional open techniques.