A comparison of results between percutaneous transforaminal endoscopic discectomy and fenestration discectomy for lumbar disc herniation in the adolscents

Abstract

To compare the preliminary clinical outcomes of percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) for lumbar disc herniation in the adolscents and further to summarize the clinical experience. The data of 56 patients with single segment lumbar disc herniation who were adopted by our department from January 2011 to December 2013 were retrospectively studied. All patients were divided into 2 groups, including 30 patients undergoing PTED and 26 patients undergoing FD respectively. The factors including the length of skin incision, amount of intraoperative bleeding, operation time and duration of hospitalization were compared. Pfirrmann grading system was used for assessment of lumbar disc degeneration preoperatively and 1 year later. The visual analogue scale (VAS), Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) scores were used to measure the clinical outcomes. There were significant differences in the observation factors such as the skin incision length, amount of intraoperative bleeding, operation time and duration of hospitalization between the PTED and FD groups (P < 0.05). After surgery, the patients in both groups were followed up for 12 months on average respectively. The postoperative lumbar disc degeneration in PTED group was decreased than that of in FD group. The postoperative VAS scores, ODI and JOA scores at each follow-up time point in both groups were significantly improved when compared with the preoperative ones (P < 0.05). There were no statistically significant differences between the 2 groups in the JOA score improvement rate (P > 0.05). According to 'the modified MacNab criteria, there were no statistically significant differences between the 2 groups in the excellent and good rate (P > 0.05). The preliminary clinical efficacy of both PTED and FD in the treatment of single segment lumbar disc herniation in the adolscents is satisfactory. However, PTED is a better minimally invasive surgical method with such advantages as less trauma, less blood loss, early function recovery, less effect on lumbar spinal stability and so on. The short-term outcomes of PTED are similar to that of FD.