Effect of time to first ambulation on recurrence after PELD

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive surgical technique for lumbar disc herniation.
• The optimal timing for patient ambulation following PELD remains an area of investigation.
• Early mobilization is often encouraged, but its impact on surgical outcomes needs further evaluation.

Purpose of the Study:

• To investigate the relationship between the time to first ambulation and recurrence rates after PELD.
• To assess the influence of early versus delayed ambulation on patient-reported outcomes, including pain and disability.

Main Methods:

• A retrospective cohort study involving 90 patients who underwent PELD for lumbar disc herniation.
• Patients were categorized into early, middle, and late ambulation groups based on their time to first walking post-surgery.
• Outcomes measured included Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI) for function, and recurrence rates at 3-month follow-up.

Main Results:

• All 90 cases achieved a 100% success rate.
• Patients in the middle and late ambulation groups demonstrated significantly better improvements in VAS and ODI scores at 1 and 3 months compared to the early group.
• The early ambulation group exhibited significantly higher rates of postoperative recurrence and high MRI signal in the vertebral endplate area.

Conclusions:

• The timing of first ambulation is a critical factor influencing the effectiveness of PELD.
• Delayed ambulation (middle and late groups) is associated with superior short-term functional recovery and reduced recurrence rates compared to early ambulation.
• Early ambulation post-PELD may be a contributing factor to increased recurrence rates.