Technical Consideration of Interlaminar Approach in the Lumbar Disc Herniation.

Abstract With the evolution of endoscopic instruments and techniques, full-endoscopic spine surgery(FESS) has attracted more attention worldwide in recent years. At the initial stage, surgeons conducted endoscopic lumbar discectomy by the transforaminal approach. Then, interlaminar endoscopic lumbar discectomy(IELD) was brought in treating herniation disc at the L5-S1 level. The progress of the interlaminar endoscopic techniques has further broadened the indications of FESS. However, the steep learning curve of endoscopic procedures remains challenging. The IELD entails many essential skills to manage different anatomical structures of the spine. From the perspective of successful and safe IELD, the authors will discuss technical considerations in the endoscopic procedures.