Transforaminal percutaneous endoscopic discectomy in the treatment of foraminal and extraforaminal lumbar disc herniations.

The objective of this study is to evaluate the efficacy of the endoscopic technique, as applied to patients with foraminal and extraforaminal disc herniations, and to report the outcome and complications. A retrospective analysis was performed of 35 consecutive cases of foraminal and extraforaminal lumbar disc herniation managed by posterolateral endoscopic discectomy. Pain was measured by means of the Visual Analog Score. Patient satisfaction was evaluated by the Macnab outcome criteria. The median follow-up period was 18 months (range 10 to 35 months). The mean Visual Analog Score improved from 8.6 before the surgery to 3.2 after the surgery. Overall, excellent or good outcomes were obtained in 30 (85.7%) of the 35 patients at the last follow-up examination, with both these outcomes showing statistically significant improvement (P<0.01). There were no complications related to the surgery, nor was any spinal instability detected. Three patients (8.6%) experienced persistent radiculopathy and subsequently underwent open microdiscectomy at the same level. We concluded that transforaminal percutaneous endoscopic discectomy is safe and efficacious in the treatment of foraminal or extraforaminal disc herniations. However, proper patient selection is paramount to ensure a satisfactory outcome after decompression of foraminal and extraforaminal disc herniations.