Percutaneous transforaminal lumbar endoscopic discectomy: An appropriate outpatient procedure for lumbar disc pathologies in a high output tertiary care centre

Introduction: A very common problem that we come across is that of lower backache in middle aged and elderly, in which disc prolapse is far more prevalent in the population than realised. However, radicular steps like spine surgery is a frightening concept for most. In our world, where technology has undergone such advances, offering a concept like day care spine surgery that too under local anaesthesia for relief of radicular pain, will be a welcome breath. This treatment option not only works faster than epidural injection or oral pain relievers, but also is a more permanent mode of treatment in a tertiary care centre where patient load is a big issue. Objectives: The aim of this study was to determine the success and surgical outcome of percutaneous transforaminal lumbar endoscopic discectomy on patients with disc prolapse and benefit to the hospital due to rapid turnover of patients. Material and Methods: Total 20 patients were followed and reviewed in Civil Hospital, Ahmedabad from between July to December 2016. Visual Analog Scale (VAS) was used to assess relief from pain and radiculopathy and Macnab's criteria to know the patient satisfaction. Results: At the end of 6 weeks, mean post-operative VAS was 3 as compared to pre-operative 8.8 Macnab's criteria gave excellent and good results in 80% individuals. Mean hospital stay was 1.2days with no complications like dural tear or infection. One patient underwent open discectomy. Conclusion: Transforaminal lumbar endoscopic discectomy is a novel technique for most of the government tertiary care centres with many patients but lacking advanced technology. Inspite of having a steep learning curve and high one time cost of instruments, it could become gold standard as it relieves symptoms immediately reducing surgical and anaesthetic complications. It being a day care procedure results in rapid turnover of patients.