Comparison of conventional fenestration discectomy with Transforaminal endoscopic lumbar discectomy for treating lumbar disc herniation:minimum 2-year long-term follow-up in 1100 patients

Abstract

Purpose To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with transforaminal endoscopic lumbar discectomy (TELD) for treating lumbar disc herniation (LDH). Methods The clinical data of 1100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas TELD was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded. Results The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions Although conventional IFD and TELD had similar levels of efficacy in treating LDH, TELD had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.

Endoscopic and Microscopic Interlaminar Discectomy for the Treatment of Far-Migrated Lumbar Disc Herniation: A Retrospective Study with a 24-Month Follow-Up

“… 29 , 32 The results of our study show that sciatica in both the IELD and IMLD groups significantly improved and remained satisfactory at the 24-month follow-up, indicating that adequate decompression was achieved, which is in accordance with other published reports. 15 , 16 , 35–37 An interlaminar approach was used in the IELD group as the anatomic structure was easier to identify under endoscopy; this is in line with the operating habits of most spine surgeons. With the aid of 30° optics and endoscopic tilt, the surgeon can directly view far-migrated fragments in the spinal canal with limited removal of lamina or facet joints.…”

“…[11][12][13] With improvements in instrumentation and advances in minimally invasive surgical techniques, percutaneous endoscopic lumbar discectomy (PELD) has become a popular approach that has several advantages over conventional discectomy including less paravertebral muscle injury, lower risk of iatrogenic instability, and rapid recovery. [14][15][16][17] Meanwhile, percutaneous endoscopic transforaminal lumbar discectomy (PETLD) and percutaneous endoscopic interlaminar lumbar discectomy are alternatives to microscopic discectomy for the treatment of various types of LDH, including severe and extremely difficult cases. 18 However, because of anatomic barriers and disc fragmentation, the treatment of far-migrated DH remains clinically challenging.…”

Percutaneous endoscopic interlaminar discectomy via inner border of inferior pedicle approach for downmigrated disc herniation: a retrospective study

“…Percutaneous endoscopic lumbar discectomy (PELD) has become a prominent treatment procedure for lumbar disc herniation (LDH) due to advancements in minimally invasive surgical procedures [1]. Specifically, PELD has various advantages over traditional surgical discectomy, including a speedier recovery, a smaller skin incision with less scarring and muscle damage, a lower infection rate, a less painful procedure, and a shorter hospital stay [2,3].…”

Comparison of Percutaneous Endoscopic Interlaminar Discectomy and Open Fenestration Discectomy for Single-Segment Huge Lumbar Disc Herniation: A Two-year Follow-up Retrospective Study

“…Previously, several observational studies have also tried to compare the efficacy and safety of these two procedures. 16 , 17 It has been reported that both PELD and OFD are effective and safe surgical procedures for the treatment of LDH and no significant difference was found in pain and other functional scores. However, to date, few data are available on comparison of the clinical effectiveness between percutaneous endoscopic interlaminar discectomy (PEID) and OFD for HLDH.…”