OBJECTIVETo evaluate the outcomes of discectomy with transforaminal endoscope through interlaminar approach in treating lumbar disc herniation.

METHODSFrom April 2009 to April 2010, the clinical data of 27 patients with lumbar disc herniation were retrospectively analyzed. The patients were treated with discectomy by transforaminal endoscope through interlaminar approach, including 20 males and 7 females, with an average age of 41.8 years, ranging from 21 to 69 year; of them, 12 patients with "from inside to outside" approach and 17 patients with "from outside to inside" approach. All the patients were followed up. Clinical effect were evaluated according to Oswestry Disability Index (ODI) and modified MacNab standard.

RESULTSThe operation of one case was stopped because of unobvious visual field of bleeding and the one case was transferred to microendoscopic discectomy. Other operations of 25 cases were successful. Among 27 patients, 20 cases were followed up from 12 to 24 months with an average of (18.0+/-2.5) months. The mean of ODI improved from preoperative (75.4+/-7.8)% to (13.0+/-20.5)% at final follow-up (P=0.000). According to modified MacNab standard, 7 cases obtained excellent result, 9 good, 1 fair and 3 poor. Among the poor outcome, one patient accepted the classical discectomy because of recurrent herniation of same level three months later,and the other two need take medicine.

CONCLUSIONThe discectomy with transforaminal endoscope through interlaminar approach for lumbar disc herniation is effective by decompress through from outside to inside access and from inside to outside access,the former is recommended to the dural sac and nerve root compressed to collateral side by huge protrusion and the latter is recommended to relatively smaller protrusion with long time conservative therapy.