• Stylianos Kapetanakis, Nikolaos Gkantsinikoudis, and Sotirios Apostolakis.
• Spine Department and Deformities, Interbalkan European Medical Center, 55535, Thessaloniki, Greece. stkapetanakis@yahoo.gr.
• Arch Orthop Trauma Surg. 2023 Aug 1; 143 (8): 461346234613-4623.

IntroductionUpper lumbar disc herniation (ULDH) constitutes a considerably complex and rare anatomic entity. As such, there are only a handful of studies investigating the application of percutaneous transforaminal endoscopic discectomy (PTED) in the management of this cause of low back pain.Research QuestionTo elucidate the safety and effectiveness of PTED in patients with ULDH.Materials And MethodsTwenty-six (26) individuals with diagnosed ULDH (L1-L2, L2-L3) according to clinical and radiologic criteria were prospectively evaluated in a 2-year follow-up period. All patients were assessed preoperatively and at 6 weeks and 3, 6, 12, and 24 months postoperatively. Clinical evaluation was conducted with visual analogue scale for lower limb (VAS-LP) and low back (VAS-BP) pain in conjunction with Short-Form 36 (SF-36) Medical Health Survey Questionnaire. Potential complications were recorded in each follow-up interval.ResultsOne patient (3.8%) featured temporary postoperative dysesthesia that was completely resolved at 6 weeks. No other major perioperative complications were observed. Values of all studied indices were found to be statistically significantly ameliorated at the end of follow-up. Improvement was depicted to be quantitatively maximal at 6 weeks postoperatively.ConclusionsPTED constitutes a safe and effective technique for surgical management of ULDH that merits further assessment in current clinical practice in the framework of multicenter randomized controlled trials.Level Of EvidenceLevel III.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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