Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Discectomy in the Treatment of Adolescent Lumbar Disc Herniation: A Retrospective Analysis

Yu, Haijiang; Zhu, Bin; Liu, Xiaoguang

doi:10.1016/j.wneu.2021.05.007

“…Previously reported literature suggests that the PELD operation time is shorter than open surgery. 25 , 26 Interestingly, in our study, there was no difference in operative time between the two groups. We consider that one possible reason is that PEID requires an additional decompression of the dorsal side of the dural sac, which could effectively avoid further damage to the dural sac by a huge herniated disc.…”

Section: Discussioncontrasting

confidence: 43%

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

Ma¹,

Li²,

Zhang³

et al. 2022

JPR

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Purpose Both percutaneous endoscopic lumbar discectomy (PELD) and open fenestration discectomy (OFD) are effective and safe surgical procedures for the treatment of LDH. The purpose of this retrospective study was to compare the surgical outcomes of percutaneous endoscopic interlaminar discectomy (PEID) and OFD for single-segment huge lumbar disc herniation (HLDH). Patients and Methods We retrospectively analyzed 91 patients diagnosed with single-segment HLDH and treated with OFD or PEID. Visual analog scale (VAS), modified Japanese orthopedic association (mJOA) and Oswestry disability index (ODI) were used to assess clinical outcomes at preoperation and postoperatively at 3, 6, 12, and 24months. Modified Macnab criteria were applied to evaluate clinically satisfaction at the final follow-up. Results In both groups, the VAS and ODI scores at 3, 6, 12, and 24months postoperatively showed a significant decrease and the mJOA score at 3, 6, 12, and 24months postoperatively was significantly increased compared to preoperative results ( P <0.001). According to Macnab criteria at the final follow-up, the overall clinically satisfactory rate was 86.67% in the OFD group and 86.96% in the PEID group. There were no significant differences in VAS, ODI, and mJOA scores between the two groups at preoperation and postoperative 3, 6, 12, and 24months, respectively. In the PEID group, the length of hospitalization and the length of incision were significantly shorter than that in the OFD group ( P <0.0001). However, there was no significant difference in operative time between groups ( P =0.81). Conclusion Collectively, postoperative clinical results were equally favorable for both procedures, with no statistically significant difference between PEID and OFD at the two-year of follow-up. No serious complication was observed in two groups. Compared with the traditional surgery, PEID has the following benefits: less trauma, less bleeding, speedy recovery, and shorter hospitalization. Therefore, PEID may be a promising alternative to traditional surgery.

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“…Lower Lumbar Spine (L4/L5 And L5/S1) With the Anatomic Hindrance of Iliac Crest (High-Level Iliac Crest) In the central, subarticular, and foraminal zones, 5 studies 12,[41][42][43][44] provided empirical support for using the TELD method at L4/L5 and L5/S1. However, in the central and subarticular zones, Choi and Park 42 showed that foraminoplasty might be considered for L5-S1 disc herniation when choosing transforaminal access in patients with a high iliac crest (where the iliac crest is above the mid-L5 pedicle on lateral radiography).…”

Section: Transforaminal Endoscopic Lumbar Discectomy Approachmentioning

confidence: 99%

Full-endoscopic Lumbar Discectomy Approach Selection — A Systematic Review And Proposed Algorithm

Kotheeranurak

¹

,

Liawrungrueang

²

,

Quillo-Olvera

³

et al. 2023

Spine

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Study Design. A systematic review of the literature to develop an algorithm formulated by key opinion leaders.Objective. This study aimed to analyze currently available data and propose a decision-making algorithm for full-endoscopic lumbar discectomy for treating lumbar disc herniation (LDH) to help surgeons choose the most appropriate approach [transforaminal endoscopic lumbar discectomy (TELD) or interlaminar endoscopic lumbar discectomy (IELD)] for patients. Summary of Background Data. Full-endoscopic discectomy has gained popularity in recent decades. To our knowledge, an algorithm for choosing the proper surgical approach has never been proposed. Materials and Methods. A systematic review of the literature using PubMed and MeSH terms was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Patient samples included patients with LDH treated with full-endoscopic discectomy. The inclusion criteria were interventional research (randomized and nonrandomized trials) and observation research (cohort, case-control, case series). Exclusion criteria were case series and technical reports. The criteria used for selecting patients were grouped and analyzed. Then, an algorithm was generated based on these findings with support and reconfirmation from key expert opinions. Data on overall complications were collected. Outcome measures included zone of herniation, level of herniation, and approach (TELD or IELD). Results. In total, 474 articles met the initial screening criteria. The detailed analysis identified the 80 best-matching articles; after applying the inclusion and exclusion criteria, 53 articles remained for this review. Conclusions. The proposed algorithm suggests a TELD for LDH located in the foraminal or extraforaminal zones at upper and lower levels and for central and subarticular discs at the upper levels considering the anatomic foraminal features and the craniocaudal pathology location. An IELD is preferred for LDH in the central or subarticular zones at L4/L5 and L5/S1, especially if a high iliac crest or high-grade migration is found.

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“…Surgical options for LDH include fenestration, laminectomy, and lumbar fusion, but the traditional surgical approaches are highly damaging to the paravertebral soft tissues and affect the stability of the spine [ 5 , 6 ]. With the development of spine surgery theory, spine surgery techniques, and endoscopic visualization, as one of the minimally invasive decompression procedures, percutaneous endoscopic lumbar discectomy (PELD) has achieved significant clinical efficacy in the treatment of LDH [ 7 , 8 ]. PELD has the following advantages: (1) It can avoid the disadvantages of traditional surgery, such as tissue adhesions, soft tissue damage, and influence on the stability of the spine.…”

Section: Introductionmentioning

confidence: 99%

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Zhu

¹

,

Yao

²

,

Huang

³

et al. 2022

Applied Bionics and Biomechanics

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Objective. Spinal surgery is gradually moving toward minimally invasive surgery, but there is still some lack of knowledge about the Unilateral Biportal Endoscopic (UBE) technique that has been hotly debated in recent years. We performed this systematic review and meta-analysis to clarify whether UBE is superior to percutaneous endoscopic lumbar discectomy (PELD) for relieving short-term postoperative pain and promoting functional recovery. Methods. Computer searches of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases were performed to search for studies on UBE versus PELD for single-segment lumbar disc herniation (ssLDH) from the time of database construction to Mar. 2022, and two investigators independently performed literature screening and data extraction, and evaluation of the quality of the included studies was observed as operation time, complications, and visual analogue scale (VAS) at each preoperative and postoperative stage as well as Oswestry Disability Index (ODI), and meta-analysis was performed by applying the Review Manager 5.4 software. Results. Meta-analysis showed that PELD had shorter operation time ( MD = 35.36 , 95% CI (4.67, 66.04), P = 0.02 ) and had lower VAS of back pain at 3 days postoperatively ( MD = 0.62 , 95% CI (0.04, 1.19), P = 0.04 ) compared to the UBE. However, there was no statistical significance between the two groups in terms of complications ( MD = 2.53 , 95% CI (0.40, 16.11), P = 0.33 ), VAS of back pain at 30 days postoperatively ( MD = 0.05 , 95% CI (-0.19, 0.28), P = 0.70 ), VAS of leg pain at 3 days postoperatively ( MD = 0.21 , 95% CI (-0.20, 0.61), P = 0.33 ), VAS of leg pain at 30 days postoperatively ( MD = 0.09 , 95% CI (-0.29, 0.46), P = 0.65 ), and ODI at 30 days postoperatively ( MD = − 0.81 , 95% CI (-3.03, 1.41), P = 0.47 ). Conclusions. Current evidence suggests that both UBE and PELD are effective in relieving short-term postoperative pain and promoting functional recovery, and there is no difference in complications between them; UBE requires longer operation time, and PELD may be superior in relieving immediate postoperative pain. This trial is registered with PROSPERO ID: CRD42021287810.

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Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Discectomy in the Treatment of Adolescent Lumbar Disc Herniation: A Retrospective Analysis

Cited by 12 publications

References 23 publications

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

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

Full-endoscopic Lumbar Discectomy Approach Selection — A Systematic Review And Proposed Algorithm

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

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