Abstract
BackgroundPercutaneous endoscopic lumbar discectomy is a relatively new technique. Very few studies have reported the clinical outcome of percutaneous endoscopic discectomy in terms of quality of life and return to work.Method55 patients with percutaneous endoscopic lumbar discectomy done from 2002 to 2006 had their clinical outcomes reviewed in terms of the North American Spine Score (NASS), Medical Outcomes Study Short Form-36 scores (SF-36) and Pain Visual Analogue Scale (VAS) and return to work.ResultsThe mean age was 35.6 years, the mean operative time was 55.8 minutes and the mean length of follow-up was 3.4 years. The mean hospital stay for endoscopic discectomy was 17.3 hours. There was significant reduction in the severity of back pain and lower limb symptoms (NASS and VAS, p < 0.05) at 6 months and 2 years. There was significant improvement in all aspects of the Quality of Life (SF-36, p < 0.05) scores except for general health at 6 months and 2 years postoperation. The recurrence rate was 5% (3 patients). 5% (3 patients) subsequently underwent lumbar fusion for persistent back pain. All patients returned to their previous occupation after surgery at a mean time of 24.3 days.ConclusionPercutaneous endoscopic lumbar discectomy is associated with improvement in back pain and lower limb symptoms postoperation which translates to improvement in quality of life. It has the advantage that it can be performed on a day case basis with short length of hospitalization and early return to work thus improving quality of life earlier.
Highlights
The surgical treatment of lumbar disc herniation constitutes a large part of orthopedic practice and it has evolved considerably in terms of surgical technique and instrumentation.Percutaneous endoscopic discectomy is a relatively new technique for removing lumbar disc herniation
The advantage of percutaneous endoscopic discectomy is that the disc is approached posterolaterally through the triangle of Kambin [1,2] without the need for bone or facet resection preserving spinal stability. [1,2,3,4] There is less damage to muscular and ligamentous structures
Many studies [1,2,3,4,5,6,7,8] have shown the efficacy of percutaneous endoscopic discectomy with good clinical outcomes, there are very limited reports of how this translates to quality of life improvement and ability to return to work
Summary
The surgical treatment of lumbar disc herniation constitutes a large part of orthopedic practice and it has evolved considerably in terms of surgical technique and instrumentation. Percutaneous endoscopic discectomy is a relatively new technique for removing lumbar disc herniation. Many studies [1,2,3,4,5,6,7,8] have shown the efficacy of percutaneous endoscopic discectomy with good clinical outcomes, there are very limited reports of how this translates to quality of life improvement and ability to return to work. Very few studies have reported the clinical outcome of percutaneous endoscopic discectomy in terms of quality of life and return to work
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