Page 42 - Read Online

Koga et al. Mini-invasive Surg 2017;1:56-62 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.04
www.misjournal.net
Topic: Percutaneous endoscopic system for spinal diseases Open Access

Minimal laminectomy using the interlaminar

approach for percutaneous endoscopic

lumbar discectomy

Hisashi Koga , Hirohiko Inanami 1,2
1,2
1 Department of Orthopaedics, Iwai Orthopaedic Medical Hospital, 8-17-2 Minamikoiwa, Edogawa-ku, Tokyo 133-0056, Japan.
2 Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital, 3-17-5 Higashishinagawa, Shinagawa-ku, Tokyo 140-0002, Japan.
Correspondence to: Dr. Hisashi Koga, Department of Orthopaedics, Iwai Orthopaedic Medical Hospital, 8-17-2 Minamikoiwa, Edogawa-ku, Tokyo 133-
0056, Japan. E-mail: hkoga0808@gmail.com

How to cite this article: Koga H, Inanami H. Minimal laminectomy using the interlaminar approach for percutaneous endoscopic lumbar discectomy.
Mini-invasive Surg 2017;1:56-62.
Dr. Hisashi Koga is the Deputy Director and the Head of Education and Training Center, Iwai Orthopaedic
Medical Hospital, Japan. He obtained his MD in the University of the Ryukyu Faculty of Medicine (Okinawa,
Japan) and PhD in the Graduate Medical School of Kumamoto University (Kumamoto, Japan). His research
interest focuses on endoscopic spinal surgery and minimally invasive spinal surgery. He has authored 8 articles
on his research field in recent 3 years. He also obtained research grant from Humboldt foundation.

ABSTRACT
Article history: Aim: To evaluate the application of laminectomy using the interlaminar approach (ILA) for
Received: 18-02-2017 percutaneous endoscopic lumbar discectomy (PELD). Methods: Minimal laminectomy using
Accepted: 26-02-2017 the ILA for PELD was performed in 13 patients with lumbar disc herniation (LDH). The width
Published: 30-06-2017 of the interlaminar space, shape of the caudal margin of the upper vertebral laminae (CM-UVL),
LDH size, and caudal migration grade were radiologically evaluated. Ten LDHs were removed
Key words: via the shoulder of the corresponding nerve root, and three via the axilla of the corresponding
Percutaneous endoscopic lumbar nerve root and dural sac. Bone status was evaluated preoperatively and postoperatively using
discectomy, two- and three-dimensional computed tomography. Results: All patients (mean age 46.3
lumbar disc herniation, years) underwent PELD at a single spinal level, mostly at L5/S1. Compared with a previous
interlaminar approach, study without laminectomy, the mean operative duration (57.5 min) and operative outcome,
minimal laminectomy, evaluated using the modified Japanese Orthopaedic Association and Numerical Rating Scale
minimally invasive scores, were similar; no complications were observed. However, the width of the interlaminar
space was significantly narrower, and eight cases revealeda narrow interlaminar space (width <
20 mm and/or lost concave shape of CM-UVL). Conclusion: Minimal laminectomy using the
ILA for PELD is feasible for treating LDH with the narrow space and highly migrated LDH.
INTRODUCTION is one of the most sophisticated operative procedures
for the treatment of lumbar disc herniation (LDH). [1-5]
Percutaneous endoscopic lumbar discectomy (PELD) However, PELD has an anatomical limitation for
Quick Response Code:
This is an open access article licensed under the terms of Creative Commons Attribution 4.0 International
License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution,
and reproduction in any medium, as long as the original author is credited and the new creations are licensed under the
identical terms.
For reprints contact: service@oaepublish.com

56 © 2017 OAE Publishing Inc. www.oaepublish.com