Body Image and Cosmesis after Percutaneous Transforaminal Endoscopic Discectomy versus Conventional Open Microdiscectomy for Sciatica.

Autor:	Gadjradj PS; Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, USA.; Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., Depauw PR; Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., Schutte PJ; Department of Neurosurgery, Alrijne Hospital, Leiden, The Netherlands., Vreeling AW; Department of Orthopedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands., Harhangi BS; Department of Neurosurgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2024 Mar; Vol. 14 (2), pp. 390-399. Date of Electronic Publication: 2022 May 24.
DOI:	10.1177/21925682221105271
Abstrakt:	Study Design: Randomized controlled trial. Objective: Percutaneous transforaminal endoscopic discectomy (PTED) was introduced as a less invasive procedure to treat sciatica. Even though the PTED has a small scar size, it is unknown if PTED also leads to better scar-related patient-reported outcomes. Therefore, we aimed to compare scar-related outcomes between patients undergoing PTED vs open microdiscectomy. Methods: Patients with at least 6 weeks of radiating leg pain were randomized in a 1:1 ratio to PTED or open microdiscectomy. Scar-related patient-reported outcomes were measured using the Body Image Score (BIS), Cosmesis Scale (CS) and a 0-10 numeric rating scale (NRS) on scar esthetic. Results: Of the 530 included patients, 286 patients underwent PTED and 244 underwent open microdiscectomy as allocated. At 12 months of follow-up, 95% of the patients had data available. At 12 months, the BIS was 6.2 ± 1.7 in the PTED-group and 6.6 ± 1.9 in the open microdiscectomy group (between-group difference .4, 95% CI .2 to .7). CS was 21.3 ± 3.0 in the PTED-group and 18.6 ± 3.4 in the open microdiscectomy group (between-group difference -2.7, 95% CI -3.1 to -2.3). Average NRS for scar esthetic was 9.2 ± 1.3 and 7.8 ± 1.6 in the PTED and open microdiscectomy groups, respectively (between-group difference -1.4, 95% CI -1.6 to -1.2). Conclusions: PTED leads to a higher self-rated scar esthetic as compared to open microdiscectomy, while self-reported body image seems to be comparable between both groups. Therefore, from an esthetic point, PTED seems to be the preferred technique to treat sciatica. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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