The Role of Full-Endoscopic Lumbar Discectomy in Surgical Treatment of Recurrent Lumbar Disc Herniation: A Health-Related Quality of Life Approach

Abstract

Objective: To investigate the utility of full-endoscopic lumbar discectomy (FELD) in surgical treatment of recurrent lumbar disc herniation (RLDH). Methods: Forty-five patients were prospectively studied. All patients were subjected to FELD for RLDH. They were assessed preoperatively and in regular intervals at 6 weeks and 3 months, 6 months, and 12 months postoperatively. Evaluation was conducted with visual analogue scale for leg (VAS-LP) and low back (VAS-BP) pain. Short-Form 36 Health Survey Questionnaire was utilized for health-related quality of life assessment. Results: All studied parameters featured statistically significant amelioration at all follow-up intervals. Maximal improvement was in general at 6 weeks observed, with subsequent lesser improvement until 6 months and stabilization until the end of follow-up. Comparative assessment indicated that VAS-BP displayed quantitatively lower improvement, whereas physical function, bodily pain, and role-emotional parameters demonstrated greater amelioration. Conclusion: FELD is associated with a favorable impact in postoperative daily life of patients with RLDH.

A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery

“…64,67 Endoscopic lumbar discectomy has generally shown to improve health-related quality of life. 68 In a systematic review and meta-analysis of IELD in comparison with TELD, Chen et al 69 showed that IELD and TELD are equally safe and effective for treating L5/ S1 lumbar disc herniations, with IELD being superior in terms of radiation exposure and operative time. Similar positive findings in terms of clinical results have been found for L3/4 and L4/5 discectomy.…”

“…IELD for disc herniation at L5/S1 is gaining popularity for both contained and non-contained disc herniations and high-migration disc cases [ 64 , 67 ]. Endoscopic lumbar discectomy has generally shown to improve health-related quality of life [ 68 ]. In a systematic review and meta-analysis of IELD in comparison with TELD, Chen et al [ 69 ] showed that IELD and TELD are equally safe and effective for treating L5/S1 lumbar disc herniations, with IELD being superior in terms of radiation exposure and operative time.…”

The role of full-endoscopic lumbar discectomy in patients with neurodegenerative disorders: Technical note and short literature review

“…[1,2,9,10] We, therefore, performed a minimally invasive TFED (e.g., preservation of dorsal musculature and spine anatomic elements, diminished traumatization, as well as minimization of intraoperative hemorrhage) under local anesthesia with mild sedation. [4][5][6][7][8] FELD has been performed in other patients with accompanying neurodegenerative disorders/Parkinson's disease (PD) [ Table 2]. [4,5] Kapetanakis et al first described performing TFED for LDH in 11 patients with PD versus ten patients with LDH and no accompanying comorbidities' comparable clinical improvement were observed in both groups.…”

“…Further, advantages include the ability to perform transforaminal full-endoscopic discectomy (TFED) or interlaminar full-endoscopic discectomy under local anesthesia and mild sedation. [4][5][6][7][8]…”

Full-Endoscopic Lumbar Discectomy for Recurrent Lumbar Disc Herniation: A Retrospective Study with Patient-Reported Outcome Measures

“…Despite its low invasiveness, the FELD-IL technique might still be challenging for a patient with a history of surgery via interlaminar space occupied by operative scar tissue. However, there are not many available reports regarding information for safety and clinical outcomes of FELD via IL and TF approaches for recurrent disc herniation [12][13][14][15] .…”