Published online Jul 18, 2025. doi: 10.5312/wjo.v16.i7.106570
Revised: March 28, 2025
Accepted: May 26, 2025
Published online: July 18, 2025
Processing time: 137 Days and 16.9 Hours
Far lateral lumbar disc herniation (FLLDH) is a special type of lumbar disc herniation with high rate of missed diagnosis. Selective nerve root block (SNRB) has special advantages in identifying the responsible nerve root. Percutaneous transforaminal endoscopic discectomy (PTED) is a minimally invasive and effe
To explore the diagnosis and treatment process, surgical technique and clinical efficacy of PTED combined with SNRB to treat FLLDH.
This is a multicenter center, retrospective, observational study. Between January 2020 and January 2022, 32 patients were initially diagnosed with FLLDH. All the patients were identified using SNRB to determine the responsible segment and involved nerve roots. Because of poor symptomatic control following SNRB, 2 patients were excluded. 30 patients diagnosed with FFLDH underwent PTED. The clinical characteristics, operative and postoperative outcomes, complication and subsequent follow-up were collected.
30 patients who underwent SNRB combined with PTED were followed up. The average visual analogue scale (VAS)-leg score, VAS-back score, Oswestry disability index (ODI) score at the Follow-up (1 day, 1 month, 3 months and last follow-up) were significantly different compared per-operation. According to the modified Macnab efficacy evaluation standard, the satisfaction degree at the last follow-up was excellent (28, 93.33%), good (1, 3.33%), medium (1, 3.33%) and poor (0, 0%).
SNRB provides an effective method for the definite diagnosis of FLDH and responsible nerve roots. Combination therapy offers several advantages including minimal invasiveness, precision, effectiveness, safety and low recurrence rates.
Core Tip: This study assessed percutaneous transforaminal endoscopic discectomy (PTED) combined with selective nerve root block (SNRB) for far lateral lumbar disc herniation (FLLDH) in 30 prospectively recruited patients. The clinical characteristics, operative and postoperative outcomes, complication and subsequent follow-up were collected. These results suggest that SNRB provides an effective method for the definite diagnosis of FLDH and responsible nerve roots. SNRB combined with PETD for treating FLLDH offers several advantages including minimal invasiveness, precision, effectiveness, safety and low recurrence rates, thus warranting further investigation.