Clinical Outcomes of Transforaminal Full Endoscopic Discectomy in the Management of Upper Lumbar Disc Herniation: A Prospective Study

Abstract

Objective:  This study analyzes the clinical effects and possible adverse events that occur after performing Full Endoscopic Lumbar Spine Surgery (FELSS) through the transforaminal approach when treating upper lumbar disc herniation.

Methods:  This prospective study recruited patients with Upper Lumbar Disc Herniation (ULDH) who underwent transforaminal full Endoscopic Lumbar Spine Surgery at the Farooq Endoscopic Spine Institute, Afridi Medical Complex, from February 2020 to January 2023, with a 1-year follow-up. Those patients who have Symptoms refractory to at least six weeks of conservative management, including physiotherapy, analgesics, and epidural steroid injections, were included. Visual analogue scale and Oswestry disability index were the main outcome measures used, along with reporting the complications.

Results:  During postoperative months 1, 6, and 12, the patients experienced significant VAS and ODI score enhancements, which reached 1.5 ± 0.6 VAS and 12.5 ± 5.0 ODI (p < 0.001). Of the patients, 83.1% managed to return to work, and daily activities were resumed by 89.2% of the population. Three patients (6.38%) showed drastic improvements as they were pain-free and achieved standing position, while preoperatively they were brought on a wheelchair. The surgical procedures resulted in four complications affecting 2.4% of patients through dural tear, as well as 4.2% developing epidural hematomas.

Conclusion:  The transforaminal FELSS surgical method represents a reliable and protected strategy to treat upper lumbar disc herniation while producing considerable positive treatment results. Surgeons can expect better patient recovery when medical treatment occurs soon after symptoms start and the patient has no neurological issues.