Zhaojun Song1, Maobo Ran1, Juan Luo2, Kai Zhang3, Yongjie Ye1, Jiazhuang Zheng1, Zhi Zhang4. 1. Spine Surgery Department of Suining Central Hospital, Suining, Sichuan, People's Republic of China. 2. Medical Record Department of Suining Central Hospital, Suining, Sichuan, People's Republic of China. 3. Day Surgery Unit of Suining Central Hospital, Suining, Sichuan, People's Republic of China. 4. Spine Surgery Department of Suining Central Hospital, Suining, Sichuan, People's Republic of China. zhangzhispine@163.net.
Abstract
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) is satisfactory for hospitalized patients with lumbar disc herniation (LDH). Currently, only a few studies have reported about the day surgery patients undergoing PELD. METHODS: A total of 267 patients with LDH underwent PELD during day surgery and were followed up for at least 3 years. Clinical outcomes were assessed using the visual analog scale (VAS) for leg and lower back pain (VAS-B and VAS-L, respectively) and the Oswestry disability index (ODI). The radiological outcomes, such as lumbar lordosis (LL), sacral slope (SS), the disc-height ratio, and disc instability, were recorded and compared. The clinical effects between patients treated by PELD during day surgery and microendoscopic discectomy (MED) for contemporaneous hospitalized 116 patients with LDH were compared. RESULTS: Patients treated by PELD had lower blood loss and shorter hospital stay (P < 0.001) compared to those treated by MED. VAS-L, VAS-B, and ODI decreased significantly after PELD than before the operation and 3 years postoperatively. The postoperative VAS-B in the PELD group was significantly decreased than in the MED group (P = 0.001). The complications rate was 9.4% in the PELD group and 12.1% in the MED group (P = 0.471). The 1-year postoperative recurrence rate in the PELD group was much higher than that in MED group (P = 0.042). The postoperative LL and SS in the PELD group improved significantly compared to the values in the MED group (P < 0.001). According to the disc-height ratio at 3-year follow-up, a significant height loss was observed in the MED group than in the PELD group (P = 0.014). CONCLUSIONS: Although the 1-year postoperative recurrence rate was relatively high, the day surgery for LDH undergoing PELD had advantages in terms of less blood loss intraoperatively, short hospital stay, efficacy for back pain, and efficiency to maintain lumbar physiological curvature.
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) is satisfactory for hospitalized patients with lumbar disc herniation (LDH). Currently, only a few studies have reported about the day surgery patients undergoing PELD. METHODS: A total of 267 patients with LDH underwent PELD during day surgery and were followed up for at least 3 years. Clinical outcomes were assessed using the visual analog scale (VAS) for leg and lower back pain (VAS-B and VAS-L, respectively) and the Oswestry disability index (ODI). The radiological outcomes, such as lumbar lordosis (LL), sacral slope (SS), the disc-height ratio, and disc instability, were recorded and compared. The clinical effects between patients treated by PELD during day surgery and microendoscopic discectomy (MED) for contemporaneous hospitalized 116 patients with LDH were compared. RESULTS:Patients treated by PELD had lower blood loss and shorter hospital stay (P < 0.001) compared to those treated by MED. VAS-L, VAS-B, and ODI decreased significantly after PELD than before the operation and 3 years postoperatively. The postoperative VAS-B in the PELD group was significantly decreased than in the MED group (P = 0.001). The complications rate was 9.4% in the PELD group and 12.1% in the MED group (P = 0.471). The 1-year postoperative recurrence rate in the PELD group was much higher than that in MED group (P = 0.042). The postoperative LL and SS in the PELD group improved significantly compared to the values in the MED group (P < 0.001). According to the disc-height ratio at 3-year follow-up, a significant height loss was observed in the MED group than in the PELD group (P = 0.014). CONCLUSIONS: Although the 1-year postoperative recurrence rate was relatively high, the day surgery for LDH undergoing PELD had advantages in terms of less blood loss intraoperatively, short hospital stay, efficacy for back pain, and efficiency to maintain lumbar physiological curvature.
Authors: Kyung-Chul Choi; June-Ho Lee; Jin-Sung Kim; Luigi Andrew Sabal; Sol Lee; Ho Kim; Sang-Ho Lee Journal: Neurosurgery Date: 2015-04 Impact factor: 4.654
Authors: James Mooney; Nicholas Erickson; Arsalaan Salehani; Nick Laskay; Anil Mahavadi; Adeel Ilyas; Bipul Mainali; Nitin Agarwal; Jakub Godzik Journal: N Am Spine Soc J Date: 2022-05-30