Percutaneous Endoscopic Transforaminal Discectomy versus Conventional Open Lumbar Discectomy for Upper Lumbar Disc Herniation: A Comparative Cohort Study

Abstract

Background. Percutaneous endoscopic transforaminal discectomy (PETD) is regarded as a viable alternative option for upper lumbar disc herniation (LDH). However, few studies have evaluated PETD for upper LDH, and no study has compared the advantages of endoscopic procedures versus conventional surgery. The present study was aimed at comparing the surgical outcome and safety of PETD versus conventional open lumbar discectomy in the treatment of upper LDH. Methods. Data from 42 patients treated for upper LDH from July 2015 to July 2018 were retrospectively analyzed, including 21 patients treated with PETD (PETD group) and 21 patients treated with conventional posterior lumbar discectomy (open group). The two groups were compared regarding demographic information, physical examination, radiological evaluations, and perioperative indicators. The clinical outcomes were assessed in accordance with the Oswestry Disability Index (ODI), visual analog scale (VAS), and modified MacNab criteria. Results. The postoperative ODI and VAS scores were significantly improved in both groups compared with the preoperative baseline values (P<0.001), and the satisfactory rate was 90.5% in both groups in accordance with the modified MacNab criteria. There were no significant differences between the two groups in the clinical outcomes and complication rate (P>0.05); however, compared with the open group, the PETD group had significantly less blood loss, less postoperative drainage, shorter operation time, and shorter postoperative hospitalization (P<0.001). Conclusions. PETD has a similar outcome to the conventional surgical method for the treatment of upper LDH but provides the typical advantages of minimally invasive procedures such as reduced iatrogenic injury, minimal activity restrictions, and accelerated ambulation recovery postoperatively.

Better Functional Outcome and Pain Relief in the Far-Lateral-Outside-in Percutaneous Endoscopic Transforaminal Discectomy

“…23 Li et al drew the conclusion with the same tendency in their comparative cohort study. 24 Our study showed that MD had a higher overall wound complication rate: 19.8% with 3.5% deep wound infection and 16.3% delayed wound healing. Although the deep wound infection rate of 3.5% is slightly above average, our major concern is that 14 out of 86 MD patients had delayed wound healing with maceration for 1–2 weeks.…”

Percutaneous Delta Endoscopic Decompression versus Oblique Lateral Interbody Fusion for Lumbar Spinal Stenosis

“…The PED group was with lower complications rate at 2.4% than that in the OLIF group. The reduction of operation time, blood loss and operation-related complications in the PED group can also be found in comparisons of the literature related to discectomies [41,42]. The physical components of SF-36 has been proven to be an effective, responsive and reliable tool for assessing degenerative lumbar spine conditions [43].…”

Evaluation of percutaneous endoscopic lumbar discectomy in treatment of obese adolescents with lumbar disc herniation：A retrospective study

“…With the development of minimally invasive techniques and the requirement of medical apparatus, PELD has emerged and is widely used in adult and adolescent spinal surgery. Numerous clinical studies have suggested that PELD not only has comparable e cacy compared with conventional spinal surgery, but also has the advantages of reduced blood loss, reduced tissue destruction, and faster postoperative recovery [23][24][25]. Moreover, several studies [26,27] have suggested that the application of PELD in obese adults with LDH could reduce the incidence of complications such as wound infection or poor healing.…”