Comparison of Results between Percutaneous Transforaminal Endoscopic Discectomy and Posterior Microendoscopic Discectomy for Lumbar Disc Herniation: A Report of over 1000 Cases and up to 4 Years Followup

Presented at SMISS Annual Forum 2016
By Jian Shen MD, PhD

Disclosures: Jian Shen MD, PhD B; K2M. C; Joimax.

Mohaw Valley Orthopedics, PC, Amsterdam, NY

Aims/Objectives

To compare safety and clinical outcomes of percutaneous transforaminal endoscopic discectomy (PTED) and microendoscopic discectomy (MED) for lumbar disc herniation. 

Methods

The data of over 1000 patients with single segment lumbar disc herniation who underwent surgery from August,
2011 to December 2015 were retrospectively studied including
720 patients undergoing PTED and 326 patients undergoing
MED respectively. The data including the incision size, amount
of intraoperative bleeding, operation time, complications,
as well as recurrent disc herniation and reoperation rate. Postoperative follow-up was up to 4 years postoperatively.

Low back pain and leg pain were measured by Visual Analog Scale (VAS) score. Functional outcomes were assessed by using Oswestry Disability Index (ODI). 

Results

The postoperative VAS and ODI scores at each follow-up time point in both groups were significantly improved when compared with the preoperative ones (P < 0.05). There were no statistically significant differences between the 2 groups. No patient in either groups had intraoperative nerve root injury, postoperative infection, or iatrogenic segmental instability, and both groups had similar low re-herniation/reoperation rate. However, there were significant differences in skin incision length, amount of intraoperative bleeding, dura tear, operation time between the PTED and MED groups (P < 0.05). 

Conclusions

Both PTED and MED are satisfactory and effective treatment for lumbar disc herniation. The clinical outcomes of PTED are similar to that of MED. However, PTED is a more minimally invasive surgical method with such advantages as less trauma, less blood loss, less dural tear rate.