Evaluation of Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Lumbar Disc Herniation: A Retrospective Study

Abstract

The objective of the present study was to evaluate the safety and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) and open fenestration discectomy (OFD) in the treatment of lumbar disc herniation (LDH). Methods: Patients in our hospital with LDH who received PTED (n = 71) and OFD (n = 39) from 2013 to 2014 were retrospectively studied. Patient information, including age, gender, visual analogue scale (VAS) score for low back pain and leg pain, body weight, height, Oswestry disability index (ODI), Japanese Orthopedic Association (JOA), and recurrence, was collected. The patients in the two groups were followed up for an average of 63 months after surgery. Results: A total of 136 patients completed the operation and 110 patients were followed up completely. There was no significant difference in baseline data between the two groups (P > 0.05). The postoperative low back pain, leg pain, ODI, and JOA of the two groups were better than those preoperatively (P < 0.05). One week after surgery, the recovery of PTED patients was better than that of OFD. The ODI score of the PTED group was lower than that of the OFD group (10 [8, 12] vs 14 [11, 16]; P < 0.05), the waist VAS score of the PTED group was lower than that of the OFD group (2 [2, 3] vs 3 [2, 4]; P < 0.05), the leg VAS score of the PTED group was lower than that of the OFD group (1 [0,1] vs 1 [1, 2]; P < 0.05), while the JOA score of the PTED group was higher than that of OFD group [19(16, 20) vs 12(10, 17); P < 0.05]. There were no significant differences in ODI, JOA, waist and leg VAS scores between the two groups at 1 month after surgery and at subsequent follow-up (P > 0.05). At the end of the follow up, 89.7% (35/39) of patients in the OFD group had excellent improvement in the JOA score, and 88.7% (63/71) of patients in the PTED group had an excellent improvement. There was no significant difference between the two (P > 0.05). There was also no significant difference in the recurrence rate between the two groups [(5/71) vs (3/39); P > 0.05]. [Correction added on 05 March 2021, after first online publication: "3/29" was amended to "3/39" in the preceding sentence.] Conclusion: Both PTED and OFD can achieve good mid-term efficacy in the treatment of LDH but PTED has certain advantages, including the small incision, a shorter hospital stay, and quicker, earlier recovery. However, prospective randomized controlled studies with a larger sample size are needed.

Comparison of Percutaneous Transforaminal Endoscopic Decompression and Transforaminal Lumbar Interbody Fusion in the Treatment of Single-Level Lumbar Disc Herniation with Modic Type I Changes

“…25 It has received many promising reports in the treatment of degenerative diseases of the lumbar spine. 26,27 In this study, we found that PTED surgery significantly improved leg pain in patients with MC I. However, part of the back pain still remains.…”

One‐Stage Percutaneous Endoscopic Lumbar Discectomy for Symptomatic Double‐Level Contiguous Adolescent Lumbar Disc Herniation

“…In our study, flattening of the sagittal lumbar curvature happened in seven cases (43.75%). Other studies also demonstrated that flattened spines are often associated with degeneration of multiple discs and back muscle weakness, which further significantly decreases spinal flexibility and stability [25][26][27] . The relationship between sagittal morphology of the spine and intervertebral disc degeneration in adolescents will discussed in another study we did.…”

Percutaneous transforaminal endoscopic discectomy for different types of lumbar disc herniation: A retrospective study

“… 3 In recent years, with the rapid development of minimally-invasive spine surgery, percutaneous translaminar endoscopic discectomy (PTED) has provided a less invasive technique to address LDH. 4 It has become an increasingly popular surgical procedure for the treatment of LDH due to its advantages of low invasiveness, high accuracy and quick recovery. 4 , 5 However, there are some differences in the surgical approaches for different types of LDH, which poses certain difficulties for spine surgeons.…”

“… 4 It has become an increasingly popular surgical procedure for the treatment of LDH due to its advantages of low invasiveness, high accuracy and quick recovery. 4 , 5 However, there are some differences in the surgical approaches for different types of LDH, which poses certain difficulties for spine surgeons. A steep learning curve and lack of experience can often lead to serious complications, including infections, late recurrence, nerve root damage, hypoesthesia, dural tear, vascular damage and death.…”