Abstract :
Background: Endoscopic spine techniques impart minimum approach related disruption of normal
anatomy and provide excellent visualisation and magnification of tissues. The purpose of the study is to
evaluate the functional outcome and possible complications of Destandau technique of posterior lumbar
discectomy.
Materials and Methods: One hundred and five patients were operated for lumbar disc herniation by using
Destandau technique of lumbar discectomy from July 2012 to January 2019. Minimum follow-up was 12
months and maximum was 7 years. Results were evaluated by Visual Analog Scale (VAS) and Oswestry
Disability Index (ODI) scores and MacNab’s criteria.
Results: Based on MacNab’s criteria, 87 patients (82.85%) had excellent results, 6 patients had good and
12 patients had fair results. Average VAS score for leg pain was improved from 8.3 (range 7-10; SD 1.10)
to 0.8(range 0-3; SD 0.86) and average ODI score from 69.65 (range 60-78; SD 5.5) to 4.51 (range 0-12)
at one year follow-up. Eighty eight percent patients were able to join sedentary work at 3 weeks, with
restrictions to avoid heavy manual work till 6 weeks. The complication rate was 18% which included dural
tears (3.8%), recurrent disc (3.8%), discitis (1.9%), transient neuralgia (7.61%) and superficial infection
(0.9%).
Conclusion: Destandau technique of endoscopic lumbar discectomy is a safe, effective, minimally invasive
procedure and reduces the approach related morbidity. It also allows early postoperative rehabilitation and
faster return to work. Proper training and experience is vital to overcome the steep learning curve.
Keyword :
Herniated lumbar disc, Destandau technique, Endoscopic discectomy, Minimally invasive surgery.