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Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
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Percutaneous endoscopic lumbar discectomy for lumbar disc herniation
Xinhua Li1, Yingchao Han1, Zhi Di2
1Department of Spinal Surgery, East Hospital, Tongji University School of Medicine, 150 JiMo Road, Shanghai 200120, China.
Summary
Percutaneous endoscopic lumbar discectomy (PELD) offers shorter recovery and hospital stays for lumbar disc herniation compared to standard discectomy (SD). However, both PELD and SD demonstrate similar long-term outcomes and clinical efficacy.
Area of Science:
- Neurosurgery
- Minimally Invasive Surgery
- Spinal Surgery
Background:
- Lumbar intervertebral disc herniation (LDH) is a common condition requiring surgical intervention.
- Percutaneous endoscopic lumbar discectomy (PELD) and standard discectomy (SD) are established surgical treatments for LDH.
Purpose of the Study:
- To compare the advantages and disadvantages of PELD versus SD for treating LDH.
- To evaluate the short-term and long-term outcomes of PELD compared to SD.
Main Methods:
- A meta-analysis was conducted, searching major databases (MEDLINE, EMBASE, PubMed, Web of Science, Cochrane).
- Data from four randomized controlled trials and three retrospective studies, totaling 1301 cases, were analyzed using Cochrane Collaboration's Revman 5.3 software.
Main Results:
- PELD demonstrated significantly shorter operative time, less blood loss, shorter hospital stay, and reduced mean disability period compared to SD.
- No significant differences were found between PELD and SD in visual analogue scale scores, Macnab criteria, complication rates, recurrence rates, or reoperation rates at final follow-up.
Conclusions:
- PELD offers significant short-term benefits, including faster recovery and shorter hospitalizations for LDH treatment.
- PELD is a feasible alternative to conventional posterior approaches for LDH, with comparable long-term clinical efficacy and outcomes to SD, subject to surgeon preference and patient indication.
