Comparison of Percutaneous Transforaminal Endoscopic Discectomy and Microscope‐Assisted Tubular Discectomy for Lumbar Disc Herniation

Autor: Hao Chen, De-Chun Wang, Siyu Xie, Long-Wei Chen, Lianghai Jiang, Hui Xue, Mingwei Zhao, Lantao Liu
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
Percutaneous
Visual analogue scale
medicine.medical_treatment
03 medical and health sciences
Disability Evaluation
Young Adult
0302 clinical medicine
Lumbar
Quality of life
Discectomy
Microscope
Surveys and Questionnaires
medicine
Humans
Orthopedics and Sports Medicine
Diskectomy
Percutaneous
Aged
Pain Measurement
Retrospective Studies
Orthopedic surgery
Tubular
Aged
80 and over
030222 orthopedics
Clinical Article
Lumbar Vertebrae
business.industry
Clinical outcome
Incidence (epidemiology)
Endoscopy
Middle Aged
Percutaneous transforaminal endoscopic discectomy
Low back pain
Oswestry Disability Index
Surgery
Clinical Articles
Quality of Life
Lumbar disc herniation
Female
medicine.symptom
business
030217 neurology & neurosurgery
RD701-811
Intervertebral Disc Displacement
Zdroj: Orthopaedic Surgery
Orthopaedic Surgery, Vol 13, Iss 5, Pp 1587-1595 (2021)
ISSN: 1757-7861
1757-7853
Popis: Objective The aim of the present study was to compare the clinical outcomes and quality of life following percutaneous transforaminal endoscopic discectomy (PTED) and microscope‐assisted tubular discectomy (MTD) for lumbar disc herniation (LDH). Methods This study had a retrospective design. From June 2017 to June 2018, the clinical data of 120 patients with LDH treated with PTED (60 cases, PTED group) and MTD (60 cases, MTD group) were analyzed and followed up for at least 20 months. There were 59 men and 61 women. Patients were aged between 22 and 80 years. The operation time, intraoperative blood loss, incision length, frequency of intraoperative fluoroscopy, cost, hospital stay, types of herniated discs, complications, and clinical outcomes were evaluated. Clinical outcomes were assessed using the visual analog scale (VAS), the Oswestry disability index (ODI), and the modified Macnab criteria. Short‐Form 36 (SF‐36) and the EQ‐5D‐5L were used to evaluate the quality of life of patients. The data between the two groups were compared by independent sample t‐tests. Multiple comparisons between samples were analyzed by analysis of variance. Results Compared with the MTD group, the PTED group had shorter incision length (9.20 ± 1.19 mm vs 26.38 ± 1.82 mm), less intraoperative blood loss (18.00 ± 4.97 mL vs 39.83 ± 6.51 mL), and shorter hospital stay (5.42 ± 5.08 days vs 10.58 ± 3.69 days) (P = 0.00). PTED was much more appropriate for foraminal and extraforaminal disc herniation. The incidence of paresthesia was lower in the PTED group (6.67% vs 16.67%). At each follow up, the VAS and ODI scores of all patients were significantly improved compared with those before surgery (P = 0.00). At 3 days postoperatively, the lumbar VAS score of the PTED group was significantly lower (1.58 ± 1.00 vs 2.37 ± 1.10, P = 0.00). The excellent rate of the PTED group reached 91.67%, and that of the MTD group reached 93.33%. Compared with the preoperative SF‐36 scores for physiological function, mental health, and social function, the postoperative scores were significantly improved in both groups (P = 0.00). The EQ‐5D‐5L in the PTED group increased from 0.30 ± 0.17 before the operation to 0.69 ± 0.13 after 6 months of follow up (P = 0.00) and 0.73 ± 0.14 after 20 months of follow up. The EQ‐5D‐5L in the MTD group increased from 0.28 ± 0.17 before the operation to 0.68 ± 0.13 after a 6‐month follow up (P = 0.00), and 0.73 ± 0.12 after a 20‐month follow up. Conclusion Although both PTED and MTD are effective for LDH, PTED is much more appropriate for various types of LDH and has the advantages of the low incidence of low back pain, fewer complications, and early recovery.
Schematic illustration
Databáze: OpenAIRE
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