Analysis of Clinical Results of Three Different Routes of Percutaneous Endoscopic Transforaminal Lumbar Discectomy for Lumbar Herniated Disk

Yudoyono, Farid; Kim, HyeunSung; Paudel, Byapak; Kim, KiJoon; Dalan, RullyHanafi; Ompusunggu, SevlineEstethia; Jang, Jee-Soo; Choi, JeongHoon; Chung, SungKyun; Kim, JeongHoon

doi:10.4103/2621-2064.353104

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“…Since the introduction of the contemporary endoscopic discectomy proposal in 1986 by Kambin, 1 percutaneous endoscopic lumbar discectomy (PELD) is widely used to treat various types of lumbar intervertebral disc herniation, with favorable clinical outcomes. [2][3][4] The main advantages of PELD include local anesthesia, minimal tissue destruction, favorable outcomes, rapid recovery, and minimal invasion. [5][6][7][8] Although prior investigations revealed that PELD achieves satisfactory clinical efficacy, 2,[4][5][6][7][8] literature reports and our own experiences revealed that a small number of patients still suffer from pain and disability after PELD, and some patients even require secondary surgery.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Involved in the Early and Medium-Term Poor Outcomes of Percutaneous Endoscopic Transforaminal Discectomy: A Single-Center Experience

Wu¹,

Shen²,

He³

et al. 2022

JPR

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Objective To investigate the risk factors involved in the early and medium-term poor outcomes of percutaneous endoscopic transforaminal discectomy (PETD) treatment of lumbar disc herniation (LDH) at the L4-5 level. Methods Between January 2015 and May 2020, we recruited 148 LDH patients at the L4-5 level who underwent PETD surgery. The patients were divided into Groups A and B, according to the surgical outcomes. Good and excellent outcomes were categorized into Group A, and generally good and poor outcomes were categorized into Group B. Clinical parameters (age, gender, symptom duration, hospital stay, operation time, blood loss, straight-leg raising (SLR), visual analog scale (VAS), Oswestry Disability Index (ODI) score and modified MacNab criteria) and radiologic parameters (foraminal height (FH), intervertebral height index (IHI), intervertebral angle (IVA), sagittal range of motion (sROM), and lumbar lordosis (LL)) were collected and analyzed using univariate and multiple logistic regression analyses. Results At the 6-month follow-up post operation, univariate analysis revealed that the symptom duration, SLR, IHI, and sROM were strongly associated with poor outcomes. However, multiple logistic regression analysis demonstrated that prolonged symptom duration, large SLR angel, and large sROM were independent risk factors for poor outcomes. At the 2-year follow-up post operation, univariate analysis suggested that advanced age, prolonged symptom duration, large preoperative VAS score, small FH, small IHI, and large sROM were potential risk factors for poor outcomes. However, multiple logistic regression analysis demonstrated that prolonged symptom duration, small IHI, and large sROM were independent risk factors for poor outcomes. Conclusion Our study demonstrated that prolonged symptom duration, large SLR angel, and large sROM were independent risk factors for poor outcomes immediately following PETD at the L4-5 level. However, prolonged symptom duration, small IHI, and large sROM were independent risk factors for poor outcomes at medium-term post PETD at the L4-5 level.

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