Myung-Jin Kim1, Sun-Ho Lee2, Eul-Soo Jung1, Byong-Gil Son1, Eun-Seok Choi1, Jong-Hyun Shin1, Joo-Kyung Sung3, Yong-Chul Chi1. 1. Department of Neurosurgery, Bogang Spine Hospital, Daegu, Republic of Korea. 2. Department of Neurosurgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea. Electronic address: sobotta@dreamwiz.com. 3. Department of Neurosurgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea.
Abstract
BACKGROUND: The aim of this study is to compare the clinical outcomes and complications after targeted PTED and conventional microscopic diskectomy for removing 1-level unilateral LDH and to evaluate the efficacy of PTED for the treatment of LDH. METHODS: The authors retrospectively examined 915 consecutive patients who underwent PTED (group A, 301 patients) and microscopic diskectomy (group B, 614 patients) for 1-level unilateral LDH. Patients who were treated with a diskectomy in the period from July 2003 to December 2004 were evaluated by telephone interview and institute visit. This assessment was performed at least 18 months (range, 18-36 months) after their operation. The follow-up rate in groups A and B was 97.5% (295 patients) and 96.5% (607 patients), respectively. RESULTS: Good or excellent results were obtained in 84.7% and 85.0% of groups A and B (P = .92). The rates of recurrence were 6.44% and 6.75% in groups A and B (P > .05). Twenty-eight patients (14 cases of recurrence, 5 cases of incomplete removal, 5 cases of stenosis, 2 cases of diskogenic back pain, and 2 cases of diskitis) in group A and 38 patients (26 cases of recurrence, 6 cases of incomplete removal, 2 cases of stenosis, 2 cases of diskogenic back pain, 1 case of hematoma, and 1 case of diskitis) in group B underwent reoperation. CONCLUSIONS: Based on our results, the PTED can be a reasonable alternative to a conventional microscopic diskectomy for the treatment of patients with LDH, except for those in downward far-migrating cases beneath the pedicle of the lower vertebra or in cases involving L5-S1 with a high pelvis.
BACKGROUND: The aim of this study is to compare the clinical outcomes and complications after targeted PTED and conventional microscopic diskectomy for removing 1-level unilateral LDH and to evaluate the efficacy of PTED for the treatment of LDH. METHODS: The authors retrospectively examined 915 consecutive patients who underwent PTED (group A, 301 patients) and microscopic diskectomy (group B, 614 patients) for 1-level unilateral LDH. Patients who were treated with a diskectomy in the period from July 2003 to December 2004 were evaluated by telephone interview and institute visit. This assessment was performed at least 18 months (range, 18-36 months) after their operation. The follow-up rate in groups A and B was 97.5% (295 patients) and 96.5% (607 patients), respectively. RESULTS: Good or excellent results were obtained in 84.7% and 85.0% of groups A and B (P = .92). The rates of recurrence were 6.44% and 6.75% in groups A and B (P > .05). Twenty-eight patients (14 cases of recurrence, 5 cases of incomplete removal, 5 cases of stenosis, 2 cases of diskogenic back pain, and 2 cases of diskitis) in group A and 38 patients (26 cases of recurrence, 6 cases of incomplete removal, 2 cases of stenosis, 2 cases of diskogenic back pain, 1 case of hematoma, and 1 case of diskitis) in group B underwent reoperation. CONCLUSIONS: Based on our results, the PTED can be a reasonable alternative to a conventional microscopic diskectomy for the treatment of patients with LDH, except for those in downward far-migrating cases beneath the pedicle of the lower vertebra or in cases involving L5-S1 with a high pelvis.
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