Efficacy and Safety of Fully Endoscopic Interlaminar Lumbar Discectomy in Lumbar Disc Herniation: A 6-month Prospective Analysis

Abstract

Lumbar disc herniation frequently causes radiculopathy requiring surgical intervention when conservative measures fail. Minimally invasive spine endoscopic pain procedure (MisEpp) is an emerging minimally invasive alternative to traditional microdiscectomy that allows direct central canal access with minimal disruption to surrounding structures. This prospective, single-arm study evaluated the clinical efficacy and safety of MisEpp in 50 consecutive patients with single-level lumbar disc herniation (L4–L5 or L5–S1) experiencing radiculopathy refractory to conservative management. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for leg pain and the Oswestry Disability Index (ODI) for functional disability at baseline and at 2 weeks, 3 months, and 6 months postprocedure. Postprocedure outcomes revealed continuous, highly significant improvements across all follow-up intervals ( P < 0.001). The mean VAS scores decreased from 9.48 ± 0.89 at baseline to 1.16 ± 0.91 at 6 months. Correspondingly, the mean ODI scores improved from 76 ± 4.95 to 13.62 ± 6.92. The procedure demonstrated an exceptional safety profile, yielding no complications during the procedure and no early re-operations. MisEpp is a highly safe and effective intervention for single-level lumbar disc herniation. By providing rapid, substantial, and sustained improvements in both radicular pain and functional disability alongside a favourable short term safety profile, the interlaminar endoscopic approach represents a robust, patient-centered alternative to conventional open decompression.