Percutaneous transforaminal endoscopic discectomy is a safer approach for lumbar disc herniation

Herein, we explored the safety and efficacy of the percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) in the treatment of lumbar disc herniation (LDH).

The complete clinical data of 87 LDH patients, who were admitted to the Peking University People's Hospital between May 2018 and March 2020, were retrospectively analyzed. These patients were initially separated into a control (n=39, treated with FD) and research group (n=48, treated with PTED), based on the prescribed treatments. We compared the basic operational conditions between the two groups, and assessed the surgical outcomes using the visual analogue scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association Scores (JOA), and modified MacNab scale. Lastly, we analyzed the complication incidence and life quality of patients at 1-year follow up after surgery.

All participants in both groups completed the operation. The amount of intraoperative blood loss, surgical duration, length of surgical incision, postoperative ambulation start time, and length of hospital stay were all significantly shorter in the research group as compared to the control group (P<0.05). Moreover, the VAS and ODI scores of the patients in the research group were lower than the control group at 3-months after surgery, while the JOA score was markedly higher (all P<0.05). In addition, the success rate was higher, and the complication rate lower, in the research group, compared to the control group (all P<0.05). Lastly, no statistical differences were observed in the quality of life of patients before the operation, or at 1-year follow up (P>0.05).

Based on our analyses, PTED and FD were both effective in treating LDH. However, PTED exhibited a higher success rate, faster recovery time, and was safer than FD.