Chao Liu1, Yue Zhou2. 1. Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, Chongqing, China. 2. Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, Chongqing, China. Electronic address: happyzhou_vip@163.com.
Abstract
OBJECTIVE: To compare the clinical outcomes of patients with lumbar disc herniation with bi-radicular symptoms undergoing percutaneous endoscopic lumbar discectomy (PELD) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). METHODS: From January 2008 to January 2016, 89 consecutive patients with lumbar disc herniation with biradicular symptoms were treated with PELD or MIS-TLIF. The data were collected prospectively for analysis including clinical and radiographic results after revision surgery and complications. RESULTS: During the follow-up period, the postoperative data between the 2 treatment groups showed no significant difference in the mean total postoperative visual analog score for leg pain and the Japanese Orthopedic Association and Oswestry disability index scores. In the MIS-TLIF group, the recovery rate and satisfaction rate were higher than those in the PELD group, and the difference was statistically significant. The only postoperative factor that was significantly different was postoperative back pain, which was lower in the MIS-TILF group. The other significant differences between the 2 treatment groups were associated with the complications such as intervertebral infection and adjacent segment disease. CONCLUSIONS: Both PELD and MIS-TLIF, as treatments for lumbar disc herniation with biradicular symptoms, showed favorable clinical outcomes. Compared with MIS-TLIF, PELD had the following advantages: 1) it is performed under local anesthesia and 2) there is rare possibility of "fusion disease," such as ASD. However, the PELD is also revealed several problems, including a relatively lower success rate and satisfaction, a relative higher rate of postoperative long-term chronic low back pain and the possibility of recurrence, despite the low incidence.
OBJECTIVE: To compare the clinical outcomes of patients with lumbar disc herniation with bi-radicular symptoms undergoing percutaneous endoscopic lumbar discectomy (PELD) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). METHODS: From January 2008 to January 2016, 89 consecutive patients with lumbar disc herniation with biradicular symptoms were treated with PELD or MIS-TLIF. The data were collected prospectively for analysis including clinical and radiographic results after revision surgery and complications. RESULTS: During the follow-up period, the postoperative data between the 2 treatment groups showed no significant difference in the mean total postoperative visual analog score for leg pain and the Japanese Orthopedic Association and Oswestry disability index scores. In the MIS-TLIF group, the recovery rate and satisfaction rate were higher than those in the PELD group, and the difference was statistically significant. The only postoperative factor that was significantly different was postoperative back pain, which was lower in the MIS-TILF group. The other significant differences between the 2 treatment groups were associated with the complications such as intervertebral infection and adjacent segment disease. CONCLUSIONS: Both PELD and MIS-TLIF, as treatments for lumbar disc herniation with biradicular symptoms, showed favorable clinical outcomes. Compared with MIS-TLIF, PELD had the following advantages: 1) it is performed under local anesthesia and 2) there is rare possibility of "fusion disease," such as ASD. However, the PELD is also revealed several problems, including a relatively lower success rate and satisfaction, a relative higher rate of postoperative long-term chronic low back pain and the possibility of recurrence, despite the low incidence.
Authors: Kai-Uwe Lewandrowski; Xifeng Zhang; Jorge Felipe Ramírez León; Paulo Sérgio Teixeira de Carvalho; Stefan Hellinger; Anthony Yeung Journal: J Spine Surg Date: 2020-01