RESULTS OF INTERLAMINAR ENDOSCOPIC LUMBAR DISCECTOMY (PSLD) SUPPLEMENTED BY NUCLEOPLASTY IN PATIENTS WITH LUMBOSACRAL DISC HERNIATION

Abstract

Lumbar intervertebral disc herniation remains one of the leading causes of chronic low back pain and radiculopathy, significantly affecting quality of life and functional capacity in the working-age population. The continuous development of minimally invasive spinal surgery has led to the widespread adoption of endoscopic techniques aimed at reducing surgical trauma while maintaining clinical effectiveness. Among these techniques, interlaminar endoscopic lumbar discectomy (posterior spinal lumbar discectomy, PSLD) has gained particular relevance, especially for lumbosacral disc herniations, due to its favorable anatomical access and direct visualization of neural structures. The addition of nucleoplasty may further enhance surgical outcomes by reducing intradiscal pressure and potentially decreasing the risk of recurrent herniation.

The present study aimed to evaluate the clinical and functional outcomes of interlaminar endoscopic lumbar discectomy supplemented by nucleoplasty in patients with lumbosacral intervertebral disc herniation. A prospective single-center study was conducted between 2022 and 2025 and included 32 patients with single-level disc herniation at L4–L5 or L5–S1 who underwent surgical treatment using the combined minimally invasive technique. Clinical outcomes were assessed preoperatively and at 12 months postoperatively using the Visual Analog Scale (VAS) for pain intensity, the Oswestry Disability Index (ODI) for functional status, and the MacNab criteria for overall surgical outcome.

The results demonstrated a statistically significant reduction in both leg and back pain, accompanied by a marked improvement in functional status and quality of life. Satisfactory outcomes according to the MacNab criteria were achieved in the majority of patients, with a low rate of postoperative complications and recurrence. The findings suggest that interlaminar endoscopic lumbar discectomy combined with nucleoplasty is a safe and effective surgical option for the treatment of lumbosacral disc herniation, providing favorable short- and mid-term outcomes and high patient satisfaction.