Early complication rates of uniportal Full-Endoscopic lumbar discectomy in 539 patients: a retrospective multicentre study.

Abstract

PURPOSE: Full-Endoscopic Lumbar Discectomy (FELD) is a minimally invasive surgical technique used to treat lumbar disc herniation, offering potential advantages such as reduced soft tissue trauma, shorter hospital stays, and faster recovery times. However, concerns remain regarding its complication rates, particularly infection, neurological deficit, and recurrent disc herniation. This study evaluates the safety and efficacy of the FELD in a multicentre cohort over a two-year period. METHODS: A retrospective multicentre analysis was conducted on 539 patients who underwent uniportal FELD between March 2022 and February 2024. The procedures were performed by three experienced endoscopic spine surgeons across three hospitals in Sydney, Australia. Postoperative follow-up was conducted for a minimum of three months to assess rates of surgical site infection, neurological complications, and recurrence. RESULTS: The average age of patients was 46.2 years. The most common level was L5/S1(298), least common L1/2 [3]. The analysis revealed a 0.18% [1] infection rate. 1.6% [9] required conversion to open surgery. The recurrence rate was 5.4%(29), most commonly at L4/5 level, average recurrence at 2.9 months (0.8–5.5). Neurological complications were observed in 2% [11] of cases. 2 required subsequent surgery and 3 had persistent weakness at 3 months. CONCLUSIONS: In this case series, FELD demonstrates a favourable safety profile, with low complication rates and recurrence rates comparable to traditional open techniques. The low complication rates of this series support FELD as a minimally invasive alternative for the treatment of lumbar disc herniation. Further studies with long-term follow-up are warranted to assess sustained outcomes and durability of symptom relief.