Body Image and Cosmesis after Percutaneous Transforaminal Endoscopic Discectomy versus Conventional Open...

Area of Science:

• Spine surgery
• Minimally invasive procedures
• Patient-reported outcomes

Background:

• Sciatica is often treated with discectomy, with percutaneous transforaminal endoscopic discectomy (PTED) offering a less invasive approach.
• While PTED is known for its small scar size, its impact on scar-related patient-reported outcomes compared to traditional open microdiscectomy remains unclear.

Purpose of the Study:

• To compare scar-related outcomes between PTED and open microdiscectomy for sciatica.
• To evaluate patient perceptions of scar aesthetics and body image following both procedures.

Main Methods:

• A randomized controlled trial was conducted with patients experiencing radiating leg pain for at least 6 weeks.
• Participants were randomized 1:1 to undergo either PTED or open microdiscectomy.
• Scar-related outcomes were assessed using the Body Image Score (BIS), Cosmesis Scale (CS), and a numeric rating scale (NRS) for scar esthetics at 12-month follow-up.

Main Results:

• A total of 530 patients were included; 286 underwent PTED and 244 underwent open microdiscectomy.
• At 12 months, the Cosmesis Scale (CS) scores were higher in the PTED group (21.3 ± 3.0) compared to the open microdiscectomy group (18.6 ± 3.4).
• The numeric rating scale (NRS) for scar esthetics was significantly better in the PTED group (9.2 ± 1.3) versus the open microdiscectomy group (7.8 ± 1.6). Body Image Scores (BIS) were comparable between groups.

Conclusions:

• Percutaneous transforaminal endoscopic discectomy (PTED) results in better self-rated scar aesthetics compared to open microdiscectomy.
• Patient-reported body image perception was similar between the two surgical techniques.
• From an esthetic perspective, PTED is suggested as the preferred surgical option for treating sciatica.