Yawei Li1, Bing Wang2, Guohua Lü1, Lei Li1, Yuliang Dai1, Zhiming Tu1, Haowen Gu1. 1. Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China. 2. Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: xywb801@csu.edu.cn.
Abstract
OBJECTIVE: To evaluate effects of holmium:yttrium-aluminum-garnet (Ho:YAG) laser ablation on postoperative low back pain and improving functional status in patients with lumbar disc herniation undergoing transforaminal endoscopic lumbar discectomy (TELD). METHODS: The study enrolled 220 patients with lumbar disc herniation who underwent TELD or TELD with Ho:YAG laser from August 2015 to September 2016. Parameters including operative time, hospitalization, complications, and recurrence were recorded. Clinical outcomes were assessed according to visual analog scale for back pain and leg pain, Oswestry Disability Index for functional status, and modified MacNab criteria for patient satisfaction. RESULTS: Minimal 2-year follow-up was completed by 186 patients: 76 patients who underwent TELD and 110 patients who underwent TELD with Ho:YAG laser. In the group undergoing TELD, clinical outcomes of back pain and functional status exhibited a V-shaped upward trend after surgery; there were no statistically significant differences in visual analog scale for back pain and Oswestry Disability Index scores at final follow-up compared with preoperatively (P > 0.05). In the group undergoing TELD with Ho:YAG laser, postoperative visual analog scale for back pain and Oswestry Disability Index scores significantly improved compared with preoperatively (P < 0.05) exhibiting relatively consistent improvement after surgery. The only laser-related complication was a burning sensation in the ipsilateral lower limb during the thermal procedure in 2 cases. CONCLUSIONS: Performing Ho:YAG laser ablation with TELD prolonged low back pain relief and improved functional outcome during 2-year follow-up compared with TELD alone in patients with symptomatic lumbar disc herniation.
OBJECTIVE: To evaluate effects of holmium:yttrium-aluminum-garnet (Ho:YAG) laser ablation on postoperative low back pain and improving functional status in patients with lumbar disc herniation undergoing transforaminal endoscopic lumbar discectomy (TELD). METHODS: The study enrolled 220 patients with lumbar disc herniation who underwent TELD or TELD with Ho:YAG laser from August 2015 to September 2016. Parameters including operative time, hospitalization, complications, and recurrence were recorded. Clinical outcomes were assessed according to visual analog scale for back pain and leg pain, Oswestry Disability Index for functional status, and modified MacNab criteria for patient satisfaction. RESULTS: Minimal 2-year follow-up was completed by 186 patients: 76 patients who underwent TELD and 110 patients who underwent TELD with Ho:YAG laser. In the group undergoing TELD, clinical outcomes of back pain and functional status exhibited a V-shaped upward trend after surgery; there were no statistically significant differences in visual analog scale for back pain and Oswestry Disability Index scores at final follow-up compared with preoperatively (P > 0.05). In the group undergoing TELD with Ho:YAG laser, postoperative visual analog scale for back pain and Oswestry Disability Index scores significantly improved compared with preoperatively (P < 0.05) exhibiting relatively consistent improvement after surgery. The only laser-related complication was a burning sensation in the ipsilateral lower limb during the thermal procedure in 2 cases. CONCLUSIONS: Performing Ho:YAG laser ablation with TELD prolonged low back pain relief and improved functional outcome during 2-year follow-up compared with TELD alone in patients with symptomatic lumbar disc herniation.