{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:16:07Z","timestamp":1793297767325,"version":"4.5.0"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n               Background\u2003The interlaminar and transforaminal approaches are commonly employed in full endoscopic lumbar spine surgery. Both approaches are well-suited for addressing specific types of lumbar disc herniation, particularly at the L4\/5 level.<\/jats:p><jats:p>\n               Objective\u2003This article compares the clinical outcomes of full endoscopic discectomy for L4\/5 central\u2013paracentral disc herniation between the interlaminar and transforaminal approaches.<\/jats:p><jats:p>\n               Materials and Methods\u2003Sixty patients were randomly assigned to either a full endoscopic interlaminar discectomy group or a full endoscopic transforaminal discectomy group, with 30 patients each. The procedures were performed by a single spine surgeon at our institution between 2017 and 2019. Over a 2-year follow-up period, various parameters, including operative time, postoperative hospitalization duration, Visual Analog Scale (VAS) scores for leg and back pain, Oswestry Disability Index (ODI), and modified MacNab criteria, were assessed and compared between the two groups. Additionally, the complication rates were documented.<\/jats:p><jats:p>\n               Results\u2003The two full endoscopic approaches resulted in significant improvements in back\u2013leg pain measured by the VAS and in the ODI scores postsurgery. A comparison between the two approaches revealed a significant difference in the ODI score at the 6-week postoperative mark (p\u2009=\u20090.02). However, other clinical outcome parameters did not show significant differences at the other follow-up time points. Postoperative dysesthesia was more prevalent in patients who underwent endoscopic transforaminal discectomy (p\u2009&lt;\u20090.05). The operative time was notably longer for the interlaminar approach compared with the transforaminal approach (62.6\u2009\u00b1\u200918.0 vs. 37.0\u2009\u00b1\u200913.6). Postoperative hospitalization time did not exhibit significant differences between the two groups.<\/jats:p><jats:p>\n               Conclusion\u2003Both the interlaminar and transforaminal approaches demonstrate similar clinical outcomes in treating central\u2013paracentral L4\/5 disc herniation. Each technique presents distinct advantages and disadvantages regarding operative time and postoperative dysesthesia. The full endoscopic interlaminar and transforaminal approaches have proven to be safe and effective methods for addressing L4\/5 central\u2013paracentral disc herniation.<\/jats:p>","DOI":"10.1055\/s-0044-1801376","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T19:39:51Z","timestamp":1735587591000},"page":"269-277","source":"Crossref","is-referenced-by-count":6,"title":["A Comparative Outcome of Full Endoscopic Lumbar Discectomy for L4\/5 Central\u2013Paracentral Disc Herniation: Interlaminar versus Transforaminal Approach: A 2-Year Prospective Randomized Controlled Follow-Up Study"],"prefix":"10.1055","volume":"20","author":[{"given":"Pritsanai","family":"Pruttikul","sequence":"additional","affiliation":[{"name":"Spine Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0554-5320","authenticated-orcid":false,"given":"Tinnakorn","family":"Pluemvitayaporn","sequence":"additional","affiliation":[{"name":"Spine Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palapat","family":"Ananpipatkij","sequence":"additional","affiliation":[{"name":"Spine Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinzang","family":"Dorji","sequence":"additional","affiliation":[{"name":"Spine Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sombat","family":"Kunakornsawat","sequence":"additional","affiliation":[{"name":"Spine Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suttinont","family":"Surapuchong","sequence":"additional","affiliation":[{"name":"Spine Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"},{"name":"Research Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warot","family":"Ratanakoosakul","sequence":"additional","affiliation":[{"name":"Spine Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitjapat","family":"Tiracharnvut","sequence":"additional","affiliation":[{"name":"Spine Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaiwat","family":"Piyasakulkaew","sequence":"additional","affiliation":[{"name":"Spine Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyabuth","family":"Kittithamvongs","sequence":"additional","affiliation":[{"name":"Research Unit, Institute of Orthopedics, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Lerdsin Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"issue":"02","key":"ref1","first-page":"4583943","article-title":"A history of endoscopic lumbar spine surgery: what have we learnt?","volume":"2019","author":"H M Mayer","year":"2019","journal-title":"BioMed Res Int"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.clineuro.2017.01.003","article-title":"Full-endoscopic versus micro-endoscopic and open discectomy: a systematic review and meta-analysis of outcomes and complications","volume":"154","author":"K Phan","year":"2017","journal-title":"Clin Neurol Neurosurg"},{"key":"ref3","first-page":"9073460","article-title":"A comparison of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for lumbar disc herniation in the Korean: a meta-analysis","volume":"2018","author":"M Kim","year":"2018","journal-title":"BioMed Res Int"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1007\/s00590-021-03065-2","article-title":"Comparison of post-operative wound pain between interlaminar and transforaminal endoscopic spine surgery: which is superior?","volume":"32","author":"P Pruttikul","year":"2022","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"09","key":"ref5","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1097\/BRS.0b013e31816c8af7","article-title":"Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study","volume":"33","author":"S Ruetten","year":"2008","journal-title":"Spine"},{"issue":"09","key":"ref6","first-page":"931","article-title":"A New full-endoscopic technique for the interlaminar operation of lumbar disc herniations using 6-mm endoscopes: prospective 2-year results of 331 patients","volume":"33","author":"S Ruetten","year":"2006","journal-title":"Spine"},{"issue":"06","key":"ref7","first-page":"547","article-title":"Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation: transforaminal versus interlaminar approach","volume":"16","author":"K-C Choi","year":"2013","journal-title":"Pain Physician"},{"issue":"S 19","key":"ref8","doi-asserted-by":"crossref","first-page":"B30","DOI":"10.1097\/BRS.0000000000001810","article-title":"Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation via an interlaminar approach versus a transforaminal approach: a prospective randomized controlled study with 2-year follow up","volume":"41","author":"H Nie","year":"2016","journal-title":"Spine"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1007\/s00132-019-03710-z","article-title":"Percutaneous endoscopic lumbar discectomy for LDH via a transforaminal approach versus an interlaminar approach: a meta-analysis","volume":"49","author":"Y Huang","year":"2020","journal-title":"Orthopade"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"e23193","DOI":"10.1097\/MD.0000000000023193","article-title":"Meta-analysis of the operative treatment of lumbar disc herniation via transforaminal percutaneous endoscopic discectomy versus interlaminar percutaneous endoscopic discectomy in randomized trials","volume":"100","author":"D-W He","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1016\/j.spinee.2014.04.022","article-title":"Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology","volume":"14","author":"D F Fardon","year":"2014","journal-title":"Spine J"},{"key":"ref12","first-page":"209","article-title":"Treatment of lumbar disc herniation: evidence-based practice","volume":"3","author":"A J Schoenfeld","year":"2010","journal-title":"Int J Gen Med"},{"issue":"22","key":"ref13","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.1097\/01.brs.0000186327.21435.cc","article-title":"An extreme lateral access for the surgery of lumbar disc herniations inside the spinal canal using the full-endoscopic uniportal transforaminal approach-technique and prospective results of 463 patients","volume":"30","author":"S Ruetten","year":"2005","journal-title":"Spine"},{"issue":"07","key":"ref14","first-page":"1417","article-title":"The Oswestry low back pain disability questionnaire (version 1.0) Thai version","volume":"90","author":"N Sanjaroensuttikul","year":"2007","journal-title":"J Med Assoc Thai"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"61","DOI":"10.36076\/ppj\/2015.18.61","article-title":"Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study","volume":"18","author":"M Komp","year":"2015","journal-title":"Pain Physician"},{"issue":"11","key":"ref16","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1007\/s00586-013-2849-7","article-title":"Exiting root injury in transforaminal endoscopic discectomy: preoperative image considerations for safety","volume":"22","author":"I Choi","year":"2013","journal-title":"Eur Spine J"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1801376.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:49:46Z","timestamp":1756360186000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1801376"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,30]]},"references-count":16,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,6,4]]},"published-print":{"date-parts":[[2025,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1801376","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,30]]}}}