Percutaneous endoscopic translaminar lumbar interbody fusion for the treatment of L5S1 intervertebral disc herniation

OBJECTIVE To observe the effeicacy and safety of percutaneous endoscopic translaminar lumbar interbody fusion (PE-TLIF) in the treatment of L5S1 intervertebral disc herniation. METHODS The clinical data of 37 patients with L5S1 intervertebral disc herniation underwent PE-TLIF from January 2018 to December 2019 were retrospectively analyzed. There were 16 males and 21 females, aged from 30 to 68 years old, with a mean of (45.62±13.57) years;body mass index was from 19.5 to 28.8 kg/m2, with a mean of (24.33±3.51) kg/m2;the course of disease was from 18 to 48 months, with a mean of (27.18±6.65) months. Operation time, intraoperative blood loss, postoperative drainage and complication rate were recorded; visual analogue scale(VAS), Japanese Orthopaedic Association (JOA) score and Oswestry Disability Index(ODI) before operation, 1 week, 6 months, 1 year after operation were observed. RESULTS The operation time ranged from 78 to 171 min, with a mean of (120.74±41.19) min;intraoperative blood loss ranged from 61 to 102 ml, with a mean of (85.26±25.44) ml;and postoperative drainage ranged from 35 to 98 ml, with a mean of (40.75±12.17) ml. Complications occurred in 8 patients, including 2 cases of nerve injury, 4 cases of pain aggravated, 1 case of internal fixation loosening, and 1 case of intervertebral space nonfusion. The VAS, JOA score and ODI significantly improved after 1 week, 6 months, and 1 year after operation (P<0.05). CONCLUSION PE-TLIF for the treatment of L5S1 intervertebral disc herniation has the advantages of less intraoperative blood loss, less trauma, and satisfactory short-term curative effect. It can effectively improve the symptoms of patients. However, the incidence of complications in the actual clinical practice is frequent, and surgical indications need to be strictly grasped.