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Posterolateral Endoscopic Excision for Lumbar Disc Herniation: Surgical Technique, Outcome, and Complications in 307 Consecutive Cases

Yeung, Anthony Tung, MD,* and; Tsou, Paul Moody, MD

Clinical Case Series
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SDC

Study Design. A retrospective review involving 307 consecutive cases of lumbar disc herniation managed by posterolateral endoscopic discectomy was conducted.

Objectives. To describe a contemporary posterolateral endoscopic decompression technique for radiculopathy secondary to lumbar disc herniation; to evaluate the efficacy of the technique as it is applied to lumbar disc herniation including primary herniation, reherniation, intracanal herniation, and extracanal herniation; and to report outcome and complications.

Summary of Background Data. The concept of percutaneous posterolateral nucleotomy was introduced in 1973. The development of the related equipment and technique had witnessed a slow and lengthy evolution.

Method. A retrospective assessment of 307 patients was performed at least 1 year after their index operation. The outcome was graded according to a modified MacNab method. A patient-based outcome questionnaire also was incorporated into the study.

Results. The surgeon-performed assessment showed satisfactory results in 89.3% of the cases. The rate of response to the questionnaire was 91%. The responses indicated that 90.7% of the respondents were satisfied with their surgical outcome and would undergo the same endoscopic procedure again if faced with a similar herniation in the future. The poor outcome occurred in 10.7% of the primary group and 9.7% of the questionnaire group. The combined major and minor complication rate was 3.5%.

Conclusions. The surgical outcome of posterolateral endoscopic discectomy for lumbar disc herniation is comparable with that for the traditional open transcanal microdiscectomy. Intracanal and extracanal herniations, reherniations, and incidental lateral recess stenosis can be addressed by the same approach.

From *Arizona Orthopedic Surgeons, Phoenix, Arizona, and

the †UCLA Department of Orthopaedic Surgery, Santa Monica, California.

Acknowledgment date: January 25, 2001.

First revision date: May 29, 2001.

Second revision date: August 3, 2001.

Acceptance date: April 1, 2001.

Address reprint requests to

Paul Moody Tsou, MD

Department Of Orthopaedic Surgery

UCLA School of Medicine

2001 Santa Monica Boulevard

Suite 1190 West

Santa Monica, CA 90404

E-mail:ptsou@aol.com

Device status/drug statement: The manuscript submitted does not contain information about medical device(s) or drug(s).

Conflict of interest: No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2002 Lippincott Williams & Wilkins, Inc.