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Clinical Outcomes at 2-Year Follow-Up Comparing Open Surgery and Percutaneous Laser Disc Decompression for Radicular
Amir Saied Seddighi1, Afsoun Seddighi1, Seyedmorteza Hosseini1
1Shohada Tajrish Neurosurgical Center of Excellence, Functional Neurosurgery Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background:
This study aims to compare the clinical outcomes of percutaneous laser disc decompression (PLDD) and open surgery for patients with radicular sciatic pain caused by lumbar disc herniation over a 2-year follow-up period.
Methods:
In a prospective randomized controlled trial, 84 patients with chronic radicular pain were assigned to either the open surgery group (n = 42) or the PLDD group (n = 42). Patients were evaluated at baseline, and at 4, 8, 24, 48, and 96 weeks postintervention. Outcome measures included the Roland-Morris Disability Questionnaire, Visual Analog Scale for leg and back pain, and the Short Form-36 bodily pain and physical functioning subscales. Resurgery rates were also recorded.
Results:
No significant differences in Roland-Morris Disability Questionnaire, Visual Analog Scale for leg and back pain, or Short Form-36 scores were observed between the 2 groups at any follow-up time points. Both groups showed improvement in disability and pain scores over time, with similar patterns of recovery. The median resurgery rates were 19.0% for open surgery and 31.0% for PLDD (P = 0.314), indicating comparable long-term effectiveness of both treatments.
Conclusions:
This study demonstrates that PLDD and open surgery provide similar long-term outcomes in terms of disability, pain relief, and physical functioning for patients with radicular sciatic pain. While PLDD is associated with a higher resurgery rate, it remains a viable minimally invasive alternative to open surgery. Further research is warranted to refine patient selection criteria and improve procedural efficacy for both interventions.
