Long-Term Outcomes of Patients with Lumbar Disc Herniation Treated with Percutaneous Discectomy: Comparative Study with Microendoscopic Discectomy

Abstract

We assessed the long-term outcomes of patients with lumbar disc herniation treated with percutaneous lumbar discectomy (PLD) or microendoscopic discectomy (MED). A retrospective study was performed in consecutive patients with lumbar disc herniation treated with PLD (n = 129) or MED (n = 101) in a single hospital from January 2000 to March 2002. All patients were followed up with MacNab criteria and self-evaluation questionnaires comprising the Oswestry Disability Index and Medical Outcomes Study 36-Item Short-Form Health Survey. Several statistical methods were used for analyses of the data, and a p value of <0.05 was considered to be statistically significant. A total of 104 patients (80.62%) with PLD and 82 patients (81.19%) with MED were eligible for analyses, with a mean follow-up period of 6.64 +/- 0.67 years and 6.42 +/- 0.51 years, respectively. There were no significant differences between the two groups in age, number of lesions, major symptoms and physical signs, and radiological findings. According to the MacNab criteria, 75.96% in the PLD group and 84.15% in the MED group achieved excellent or good results, respectively, this was statistically significant (p = 0.0402). With the Oswestry Disability Index questionnaires, the average scores and minimal disability, respectively, were 6.97 and 71.15% in the PLD group and 4.89 and 79.27% in the MED group. Total average scores of Medical Outcomes Study 36-Item Short-Form Health Survey were 75.88 vs. 81.86 in PLD group vs. MED group (p = 0.0582). The cost and length of hospitalization were higher or longer in MED group, a statistically significant difference (both p < 0.0001). Long-term complications were observed in two patients (2.44%) in the MED group, no such complications were observed in the PLD group. Both PLD and MED show an acceptable long-term efficacy for treatment of lumbar disc herniation. Compared with MED patients, long-term satisfaction is slightly lower in the PLD patients; complications, hospitalization duration, and costs in PLD group are also lower.

Percutaneous Disc Decompression for Lumbar Radicular Pain: A Review Article

“…Only 2 observational studies on APLD have been published since 2010. Liu et al . retrospectively compared the results of patients who underwent APLD against those who underwent microendoscopic discectomy.…”

“…Only 2 observational studies on APLD have been published since 2010. Liu et al 27 retrospectively compared the results of patients who underwent APLD against those who underwent microendoscopic discectomy. According to McNab criteria, 75.96% of patients who underwent APLD reported good to excellent results at 6-year follow-up.…”

Comparison of Two Minimally Invasive Approaches to the Thoracolumbar Spinal Canal in Dogs

“…Minimally invasive procedures for treatment of IVDH, such as microendoscopic discectomy (MED), have gained popularity in people because they have decreased incision size, morbidity, and hospitalization time while achieving comparable functional results to open procedures . In small animals, minimally invasive surgery is becoming more popular, with the goal of effectively treating pathology with minimal disturbance of normal anatomy.…”

Systematic review of microendoscopic discectomy for lumbar disc herniation

“…Nine studies were left following review of the title and abstracts. Four studies were excluded as they did not randomise participants [9][10][11][12], one study did not have an appropriate intervention group [13] and one study included participants that were having revision surgery [14]. A total of four studies met the eligibility criteria and were included in this systematic review [15][16][17].…”