The influence of body mass index on efficacy and outcomes of percutaneous transforaminal endoscopic surgery (PTES) for the treatment of lumbar degenerative diseases: a retrospective cohort study.
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Abstract
Background: To investigate and quantify the influence of body mass index (BMI) on the efficacy and outcomes of percutaneous transforaminal endoscopic surgery (PTES), a novel minimally invasive surgical technique in the treatment of lumbar disc herniation (LDH).
Methods: A total of 55 patients suffering from single-level LDH with or without high iliac crest, scoliosis or calcification, who underwent PTES in our department from January 2019 to December 2021 were retrospectively analyzed. Patients were divided into two groups according to BMI. The operative events of two groups including X-ray projection, operation time, blood loss and length of stay were compared. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy and outcomes of the surgery. Differences in complications and recurrences between two groups were also analyzed.
Results: 55 patients were divided into obese and nonobese groups according to their BMI (33.03 vs. 23.07). There was no significant difference in X-ray projection (times), operation time (mins), blood loss (mL) and length of stay (days) between two groups (7/5-11 vs. 5/5-10, 58.17 ± 9.20 vs. 53.65 ± 10.06, 6.41 ± 1.43 vs. 5.50 ± 2.45, 3.17 ± 1.44 vs. 2.96 ± 0.53, P > 0.05). Both groups demonstrated a significant decrease in ODI (12.01 ± 3.57% vs. 67.16 ± 9.25%, 13.92 ± 4.24% vs. 68.10 ± 9.27%, P < 0.05) and VAS (0.10 ± 0.48 vs. 8.38 ± 0.94, 0.22 ± 0.56 vs. 8.38 ± 0.86) at 24 months after the operation compared with which at the preoperative status. No significant difference in the improvement of the clinical outcomes was found between the two groups in ODI or VAS (P > 0.05).
Conclusions: With the simple orientation, easy puncture and reduced steps, PTES is an effective and safe method to both obese and normal patients with LDH.
背景：研究和量化体重指数（BMI）对经皮经椎间孔内镜手术（PTES）疗效和预后的影响，PTES是一种治疗腰椎间盘突出症（LDH）的新型微创手术技术。方法：回顾性分析我科2019年1月至2021年12月行PTES手术的55例单节段LDH伴或不伴高髂骨、脊柱侧凸或钙化患者。根据体重指数将患者分为两组。比较两组手术事件x线投射、手术时间、出血量、住院时间。采用视觉模拟评分（Visual Analogue Scale， VAS）和Oswestry残疾指数（Oswestry Disability Index， ODI）评价手术的临床疗效和预后。分析两组患者并发症及复发率的差异。结果：55例患者根据BMI分为肥胖组和非肥胖组（33.03 vs. 23.07）。两组患者x线投射（次）、手术时间（分钟）、出血量（mL）、住院时间（天）差异无统计学意义（7/5-11 vs 5/5-10、58.17±9.20 vs 53.65±10.06、6.41±1.43 vs 5.50±2.45、3.17±1.44 vs 2.96±0.53,P < 0.05）。两组患者ODI均显著降低（12.01±3.57%比67.16±9.25%,13.92±4.24%比68.10±9.27%,P < 0.05）。结论：PTES定位简单、穿刺方便、步骤少，对肥胖和正常LDH患者均有效、安全。临床试验号：不适用。
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