AbstractIntroduction: Standard surgical technique is the posterior approach discectomy. The use of an endoscope allows the same entry port and surgical technique used on vertebral canal and disc while at the same time reducing the skin incision. Aims: Aimed to studyendoscopic lumbar discectomy for a surgeon naive to endoscopic surgery but trained in open microdiscectomy. Materials and methods: This was a prospective study done in department of neurosurgery in patients who had acute onset of symptoms like low back pain with sciatica which is unilateral and whose clinical examination showed signs of definitive radiculopathy and MRI showing sequestered disc prolapse at that corresponding level.We have done 40 cases of endoscopic discectomy using a conical freehand working channel . We divided the 40 cases into 20 each, the first 20 cases represent learning curve and the next 20 post learning curve. Results: Patients who had undergone endoscopic discectomy were 40 among them 26 patients were male and 14 patients were females. All patients were between 20-65 years of age and the mean was 39.57.The most common level operated was L4-L5(31) followed by L5-S1(08). We have operated double level in one patient at L4-L5 and L5-S1. Initial 20 cases the mean duration was 58.8 minutes and it was significantly reduced to 31.55 minutes in our last 20 cases. The mean duration for all 40 cases in our series was 45.17minutes. Mean blood was 18.1ml. Mean hospital stay in our first 20 cases was 3.75 days and in our last 20 cases it was 3 days. The mean hospital stay taking in to account of all 40 cases in our series was 3.37 days or 80.8 hours.our study the mean duration to return to work was 19 days.10% of cases had complications, among them one patient had nerve root injury, 2 patient had Dural tear, and in 1 patients pain dint subside and he underwent redo open laminectomy. In our study 85% patients had excellent outcome and 2.5 patients had poor outcome. Conclusions: Endoscopic discectomy is a minimally invasive procedure with less tissue disruption to achieve the results of the traditional surgery.
Keywords: Lumbar disc prolapses; Endoscopic discectomy; Mean blood loss.