Stylianos Kapetanakis1, Nikolaos Gkantsinikoudis2, Constantinos Chaniotakis2, Georgios Charitoudis2, Panagiotis Givissis3. 1. Spine Department and Deformities, Interbalkan European Medical Center, Thessaloniki, Greece. Electronic address: stkapetanakis@yahoo.gr. 2. Spine Department and Deformities, Interbalkan European Medical Center, Thessaloniki, Greece. 3. First Orthopedic Department of Aristotle University of Thessaloniki, Papanikolaou Hospital, Exohi, Thessaloniki, Greece.
Abstract
BACKGROUND: Percutaneous transforaminal endoscopic discectomy (PTED) is a minimally invasive surgical technique used principally for the treatment of lumbar disc herniation (LDH). LDH is a frequent spinal ailment in obese individuals. The aim of this prospectively designed study was to assess for the first time in the literature the impact of PTED in postoperative parameters of health-related quality of life (HRQoL) in obese patients with LDH within a 2-year follow-up period, to further evaluate the effectiveness of PTED. METHODS: Patients with surgically treatable LDH were divided into 2 groups. Group A constituted 20 obese patients, and group B was composed of 10 patients with normal body mass index (BMI). A visual analog scale was used for pain evaluation, and the Short Form SF-36 Medical Survey Questionnaire contributed to HRQoL assessment. Follow-up was conducted preoperatively and at 6 weeks and 3, 6, 12, and 24 months postoperatively. RESULTS: Two of the 20 patients (10%) presented with severe postoperative pain, necessitating conventional microdiscectomy. All studied parameters exhibited maximal improvement at 6 months in group A and at 6 weeks in group B, with subsequent stabilization. Obese patients scored lower in all parameters compared with their healthy counterparts with normal BMI, acquiring a less favorable clinical benefit. CONCLUSIONS: PTED appears to be a generally safe and effective method for treating obese patients with LDH. However, major technical challenges that lead to a higher frequency of complications, as well as the lesser acquired clinical benefit, in obese patients may contribute to the further consideration for PTED in specific obese patients, especially on the grounds of low surgical experience.
BACKGROUND: Percutaneous transforaminal endoscopic discectomy (PTED) is a minimally invasive surgical technique used principally for the treatment of lumbar disc herniation (LDH). LDH is a frequent spinal ailment in obese individuals. The aim of this prospectively designed study was to assess for the first time in the literature the impact of PTED in postoperative parameters of health-related quality of life (HRQoL) in obesepatients with LDH within a 2-year follow-up period, to further evaluate the effectiveness of PTED. METHODS:Patients with surgically treatable LDH were divided into 2 groups. Group A constituted 20 obesepatients, and group B was composed of 10 patients with normal body mass index (BMI). A visual analog scale was used for pain evaluation, and the Short Form SF-36 Medical Survey Questionnaire contributed to HRQoL assessment. Follow-up was conducted preoperatively and at 6 weeks and 3, 6, 12, and 24 months postoperatively. RESULTS: Two of the 20 patients (10%) presented with severe postoperative pain, necessitating conventional microdiscectomy. All studied parameters exhibited maximal improvement at 6 months in group A and at 6 weeks in group B, with subsequent stabilization. Obesepatients scored lower in all parameters compared with their healthy counterparts with normal BMI, acquiring a less favorable clinical benefit. CONCLUSIONS:PTED appears to be a generally safe and effective method for treating obesepatients with LDH. However, major technical challenges that lead to a higher frequency of complications, as well as the lesser acquired clinical benefit, in obesepatients may contribute to the further consideration for PTED in specific obesepatients, especially on the grounds of low surgical experience.
Authors: Gennadiy A Katsevman; Scott D Daffner; Nicholas J Brandmeir; Sanford E Emery; John C France; Cara L Sedney Journal: Spine J Date: 2019-12-24 Impact factor: 4.166