Comparing mid-term outcomes and patient satisfaction between percutaneous endoscopic lumbar discectomy and microendoscopic discectomy for foraminal and extraforaminal lumbar disc herniations: a retrospective matched cohort study.
Sen Liu, Feng Zhao, Chun-Ping Yin, Chao-Hua Zhu, Ruo-Yu Zhao, Guo-Bin Liu, Gang Ji, Jia Chen, Hong-Yang Gao
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引用次数: 0
Abstract
Objective: This study aimed to compare the mid-term outcomes and patient satisfaction between percutaneous endoscopic lumbar discectomy (PELD) and microendoscopic discectomy (MED) for the treatment of foraminal and extraforaminal lumbar disc herniations.
Methods: A retrospective matched cohort study was conducted, including patients diagnosed with foraminal or extraforaminal lumbar disc herniations who underwent PELD or MED between January 2014 and December 2021. Patient demographics, clinical characteristics, and perioperative data were analyzed. Primary outcomes included Visual Analog Scale (VAS) scores for pain, Japanese Orthopaedic Association (JOA) scores and improvement rates for functional status, and overall satisfaction at a minimum 2-year follow-up.
Results: A total of 133 patients were included in the final analysis. The PELD group demonstrated a significantly greater reduction in VAS scores for low back pain (6.74 ± 1.21 to 1.95 ± 0.42) compared to the MED group (6.93 ± 1.17 to 2.35 ± 0.89) at the 2-year follow-up (p < 0.001). Both groups exhibited significant improvements in JOA scores, with no notable differences observed at the final follow-up. Patient satisfaction rates were higher in the PELD group, with 86% reporting high satisfaction compared to 72% in the MED group; however, this difference was not statistically significant. Logistic regression analysis identified VAS scores for low back pain, operation cost, and symptom recurrence as independent factors influencing patient dissatisfaction at 2 years post-surgery.
Conclusion: Both PELD and MED demonstrated efficacy in treating foraminal and extraforaminal lumbar disc herniations over a 2-year follow-up period. PELD, however, exhibited superior relief of low back pain. Factors, such as low back pain intensity, surgical costs, and symptom recurrence significantly impacted patient dissatisfaction, despite comparable overall satisfaction rates between the two surgical techniques.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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