Does Surgical Position Affect Percutaneous Transforaminal Endoscopic Discectomy Outcomes and Patient Satisfaction: A Single-Center Retrospective Study.

Study design: A retrospective, single-center study.

Objective: The aim of this study is to evaluate the effects of different surgical positions on clinical outcomes and patient satisfaction of percutaneous transforaminal endoscopic discectomy (PTED).

Summary of background data: The effect of lateral position (LP) versus prone position (PP) on PTED efficacy and patient satisfaction has not been entirely investigated.

Methods: This study includes 85 patients who underwent PTED surgery for lumbar disc herniation from January 1, 2021, to December 31, 2023, at Binhai New District Hospital of Traditional Chinese Medicine. The patients were categorized into the LP group (n=43) and the PP group (n=42) according to the different positions when they underwent PTED surgery. The demographic data, preoperative data, intraoperative fluoroscopy times, operative duration time, length of postoperative hospital stay, VAS scores, lumbar JOA scores, complications, and patient satisfaction were all compared between the 2 groups.

Results: PP in PTED reduced intraoperative fluoroscopy times and operative duration compared with LP. The mean intraoperative fluoroscopy times for the 42 patients in the PP group were 7.52 (SD: 1.79) compared with 12.26 (SD: 2.11) for 43 patients in the LP group, a statistically significant difference (95% CI: 3.88-5.59, P<0.001). The mean operative duration time was 84.16 minutes (SD: 11.67) in the PP group and 76.48 minutes (SD: 8.77) in the LP group, with a statistically significant difference (95% CI: 9.17- 18.21, P<0.001). Forty-one patients in the PP group (97.62%) and 38 patients in the PP group (88.37%) were satisfied with the surgery (P=0.027). There were no significant differences between the 2 groups in the length of postoperative hospital stay, complications, postoperative VAS scores (1 d, 1 mo, 3 mo, 6 mo) and postoperative JOA scores (1 wk, 1 mo, 3 mo, 6 mo).

Conclusion: PTED performed in the PP has fewer fluoroscopy times, shorter operative duration, and higher satisfaction with postoperative rehabilitation after the surgery. No difference existed in postoperative recovery between the 2 groups. However, more studies are needed to further evaluate the effect of surgical position on surgery and clinical outcomes.