Minimal laminectomy using the interlaminar approach for percutaneous endoscopic lumbar discectomy

Abstract

Aim: To evaluate the application of laminectomy using the interlaminar approach (ILA) for percutaneous endoscopic lumbar discectomy (PELD).

Methods: Minimal laminectomy using the ILA for PELD was performed in 13 patients with lumbar disc herniation (LDH). The width of the interlaminar space, shape of the caudal margin of the upper vertebral laminae (CM-UVL), LDH size, and caudal migration grade were radiologically evaluated. Ten LDHs were removed via the shoulder of the corresponding nerve root, and three via the axilla of the corresponding nerve root and dural sac. Bone status was evaluated preoperatively and postoperatively using two- and three-dimensional computed tomography.

Results: All patients (mean age 46.3 years) underwent PELD at a single spinal level, mostly at L5/S1. Compared with a previous study without laminectomy, the mean operative duration (57.5 min) and operative outcome, evaluated using the modified Japanese Orthopaedic Association and Numerical Rating Scale scores, were similar; no complications were observed. However, the width of the interlaminar space was significantly narrower, and eight cases revealeda narrow interlaminar space (width < 20 mm and/or lost concave shape of CM-UVL).

Conclusion: Minimal laminectomy using the ILA for PELD is feasible for treating LDH with the narrow space and highly migrated LDH.

Keywords

Percutaneous endoscopic lumbar discectomy / lumbar disc herniation / interlaminar approach / minimal laminectomy / minimally invasive

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