Result of Full Endoscopic Uniportal Lumbar Discectomy: Preliminary Report
Verapan Kuonsongtum MD*, Sompoch Paiboonsirijit MD**, Withawin Kesornsak MD*, Voravut Chaiyosboorana MD***, Pataravit Rukskul MD, MSc (Clinical Science), Dr Med****, Sorayouth Chumnanvej MD*****, Sebastian Ruetten MD, PhD******
Affiliation : * Division of Neurosurgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Full-Endoscopic Spine Surgery Clinic, Bangkok Hospital Medical Center, Bangkok, Thailand *** Orthopaedics Department, Royal Thai Police General Hospital, Bangkok, Thailand **** Division of Neurosurgery, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ***** Neurosurgical Unit, Surgery Department, Somdej Pra Pin Klao Naval Hospital, Naval Medical Department, Royal Thai Navy, Bangkok, Thailand ****** Department for Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology, St. Anna-Hospital Herne, University of Witten/Herdecke, Germany
Objective : Several techniques of minimal invasive spinal surgery are now becoming common roles in the
treatment of spinal diseases in many spinal centers. In the present report, the authors present a retrospective,
cohort evaluation of 46 consecutive patients who underwent full endoscopic lumbar discectomy. The purpose
of the present report was to present outcomes in this initial series of patients and to present outlines of
the operative technique; the full endoscopic uniportal lumbar discectomy. The present research is the first
preliminary report in Thailand to analyze and evaluate this new surgical technique.
Material and Method: Forty-six lumbar disc herniation operations were performed in two spinal centers
between February and June 2008, using the full endoscopic uniportal with Vertebris(cid:31) instrumentation system.
The operations were carried out by interlaminar and transforaminal approach using an 8 mm-diameter
uniportal endoscopy of Vertebris(cid:31) instrumentation. The outcome was clinically assessed, on immediate post-
operation and one month after surgery, by using Visual Analogue Scale (VAS), the Thai Version of the modified
Oswestry disability index (ODI) questionnaire (version 1.0), and modified McNab criteria.
Results : Excellent and good outcome was achieved in 87.4% of patients from Modified McNab criteria.
Forty-three patients (93.5%) had significant improvement of sciatic pain immediately after the operation.
Eight postoperative complications were demonstrated and discussed.
Conclusion : Full endoscopic uniportal lumbar discectomy is a novel and effective minimally invasive spinal
surgical technique. However, the technique requires surgical skill training and experience.
Keywords : Minimally invasive surgery, Lumbar discectomy, Full endoscopic uniportal discectomy, Visual analogue scale (VAS), Thai version of modified Oswestry disability index (ODI)
