“Inside Disc Out” Discectomy for the Treatment of Discogenic Lumbar Spinal Canal Stenosis under the Intervertebral Foramen Endoscope

This study explores a new surgical technique called “inside disc out” discectomy using an intervertebral foramen endoscope to treat discogenic lumbar spinal canal stenosis (DLSS). This technique aims to reduce the risk of nerve injury and dural laceration associated with traditional posterior-approach decompression surgeries. The “inside disc out” discectomy involves accessing the disc through the intervertebral foramen and removing the protruded disc material from the inside out. This approach aims to decompress the spinal cord and nerve roots while minimizing damage to surrounding tissues. The study found that this technique resulted in significant improvements in pain and disability scores, with a high rate of excellent or good outcomes. The authors conclude that the procedure is safe and feasible for DLSS treatment.

• 1
  All 29 patients successfully completed the operation, with an average operation time of 90 minutes. Postoperative CT scans showed full decompression of the spinal cord with no residual pressure.
• 2
  Patients experienced significant improvements in VAS scores for lower back and lower limb pain at 1, 3, 6, and 12 months postoperatively compared to preoperative scores (P < 0.01).
• 3
  The Oswestry dysfunction index also significantly improved at different time points after surgery (P < 0.01), and the modified MacNab criteria showed excellent or good results in 91.4% of patients.