A comparison study of percutaneous endoscopic interlaminar discectomy and transforaminal discectomy for L5-S1 calcified lumbar disc herniation

Abstract

Background: Percutaneous endoscopic lumbar discectomy (PELD) is a relatively safe and effective minimally invasive surgery in the treatment of calcified lumbar disc herniation (CLDH). However, studies on percutaneous endoscopic interlaminar discectomy (PEID) and percutaneous endoscopic transforaminal discectomy (PETD) for CLDH have rarely been reported. This research aimed to compare the clinical efficacy of PEID and PETD for L5-S1 CLDH.Methods: We retrospectively analyzed 54 consecutive patients with L5-S1 CLDH treated with PELD at our institution from August 2016 to August 2020. Patients were divided into PEID group (n = 28) and PETD (n = 26) group according to the surgical methods. The demographic characteristics and surgical results of the two groups were compared. Clinical outcomes were estimated by the visual analog scale (VAS) for leg pain, Oswestry disability index (ODI) and modified MacNab criteria.Results: All patients were successfully operated on by PEID or PETD. No significant differences in the demographic characteristics, intraoperative blood loss, postoperative hospital stay and complication rate were noted between the PEID and PETD groups. The excellent and good rates in the PEID group were similar to those in the PETD group (89.29% vs 88.46%, P = 1.000), whereas the PEID group exhibited superior results for operative time (min) (64.61 ± 5.60 vs 85.58 ± 8.52, P < 0.001) and fluoroscopy times (n) (2.93 ± 0.90 vs 13.35 ± 2.30, P < 0.001) compared with the PETD group.Conclusions: PEID has achieved good clinical efficacy as PETD for L5-S1 CLDH. Compared with PETD, PEID has the advantages of shorter operative time and a reduced number of fluoroscopy times in the treatment of CLDH.

Comparison of unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy for the treatment of lumbar disc herniation: A systematic review and meta-analysis

“…The operation time was available from 6 studies. [9–12,14,15] The heterogeneity was high ( I 2 = 96.42%). After sensitivity analysis of the study, it was found that Merter et al [14] was the source of heterogeneity.…”

“…The number of intraoperative fluoroscopy was available from 2 studies. [ 11 , 12 ] Analysis indicated that there was high heterogeneity among the studies ( I 2 = 0.00%) and fixed effect model was used. There are no significant difference (MD = 0.358, 95% CI [−0.097, 0.813], P = .123) between UBE and PELD group at the number of intraoperative fluoroscopy (Fig.…”

“…We decided to exclude literatures and continue the meta-analysis. When Zhu [ 11 ] is removed, heterogeneity among the studies was small ( I 2 = 7.31%), so the fixed effect model was used for meta-analysis. The results showed significant difference (MD = 3.708, 95% CI [3.202, 4.214], P = .000) between UBE and PELD group at hospital stay (Fig.…”

“…A total of 6 articles [9][10][11][12][13][14][15] that included 281 patients (142 cases for UBE group and 139 cases for PELD group) met the inclusion criteria. The concrete characteristics of the included studies were summarized in Table 2.…”

“…The incidence of complications was available from 5 studies. [9][10][11][12]15] Heterogeneity among the studies was small (I 2 = 0%), so the fixed effect model was used for meta-analysis. There are no significant difference in the incidence of complications between UBE and PELD group (MD = 0.620, 95% CI [0.166, 2.318], P = .871) (Fig.…”