Full-endoscopic trans-pars interarticularis discectomy for foraminal and extraforaminal lumbar disc herniation: surgical technique and early clinical outcomes

Introduction: Foraminal and extraforaminal lumbar disc herniations compress the exiting nerve root, causing radiculopathy. Open approaches may require facetectomy with risk of instability, while transforaminal endoscopy places instruments near the dorsal root ganglion, potentially causing postoperative dysesthesia. Research question: Is full-endoscopic trans-pars interarticularis discectomy a safe and effective treatment for foraminal and extraforaminal lumbar disc herniations? Materials and methods: This retrospective case series analyzed prospectively collected data from patients who underwent full-endoscopic trans-pars interarticularis discectomy at a single center for foraminal and extraforaminal disc herniations. Seventeen patients with complete preoperative and 6-month data were included. Outcomes were evaluated using VAS scores for leg and back pain, the Oswestry Disability Index (ODI), and the Short-Form 12 (SF-12) questionnaire. Complications and satisfaction were documented. Pre- and postoperative outcomes were compared statistically. Results: No intraoperative complications occurred. Postoperatively, there were no infections, bleeding, new neurological deficits, or recurrent herniations. Two patients (11.8%) developed transient leg dysesthesia. At 6 months, VAS leg pain improved from 8.47 ± 1.91 to 2.24 ± 2.02 and VAS back pain from 7.82 ± 2.30 to 2.06 ± 1.25 (both p < 0.001). ODI decreased from 53.53 ± 19.06 to 29.18 ± 16.25 (p < 0.001) and SF-12 physical and mental component scores improved significantly. Discussion and conclusion: The full-endoscopic trans-pars interarticularis approach appears to be a safe and effective alternative for foraminal and extraforaminal disc herniations, achieving meaningful improvements in pain, disability, and quality of life with low morbidity. Larger prospective studies with longer follow-up are needed to confirm these findings and refine indications.