Advantages of Endoscope-Assisted Disc-FX in Surgical Management of Lumbar Disc Herniation: A Report of 10 Cases

Objective: Microsurgical discectomy is the gold standard treatment for the herniated nucleus pulposus (HNP) of the lumbar spine. On the other hand, less invasive procedures have been developed and accepted rapidly. Percutaneous endoscopic lumbar discectomy (PELD) was developed as one of the minimally invasive techniques for HNP of the lumbar spine, and satisfactory outcomes have been reported. For the contained type HNP or discogenic pain, however, surgical indication of PELD is sometimes controversial. We describe our experiences of surgical treatment with DiscFX, focusing on advantages of endoscopic observation. Patients and Methods: A total of 10 patients with contained type HNP were treated with Disc-FX system. DiscFX was carried out percutaneously under local anesthesia using a cannula of 3.4 mm diameter, with a trajectory compatible with the transforaminal approach of the PELD. Endoscope was introduced intermittently in 5 patients to observe the results of each procedure. Results: Sufficient pain relief was achieved in all patients, and Japanese Orthopedic Association score improved from 7-16 (mean 13.0) to 22-29 (mean 25.9), and visual analogue scale improved from 6-10 (mean 8.0) to 0-3 (mean 1.2). Endoscopic observation enabled the procedure almost equivalent to targeted fragmentectomy, and contributed in better surgical outcome. Conclusion: Disc-FX is a promising procedure in the armamentarium of minimally invasive surgery for the selected conditions of patients, and endoscopic observation is considered to be beneficial in more accurate and adequate decompression. Citation: Hirano Y, Pawar S, Bansil R, Watanabe K (2018) Advantages of Endoscope-Assisted Disc-FX in Surgical Management of Lumbar Disc Herniation: A Report of 10 Cases. J Spine 7: 015. doi: 10.0142/2165-7939.1000015