Temporal Changes in PROMs Improvement and Recovery Kinetics Following Transforaminal Endoscopic Lumbar Discectomy

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• Transforaminal endoscopic lumbar discectomy and foraminotomy (TELD) is a growing alternative to fusion for lateral disc herniations.
• Understanding postoperative recovery timelines is crucial for managing patient expectations after TELD.
• Limited data exists on the rate of improvement following TELD procedures.

Purpose of the Study:

• To analyze trends in patient-reported outcome measures (PROMs) improvement after TELD.
• To characterize recovery kinetics following TELD for far lateral disc herniations.
• To establish postoperative improvement timelines and plateaus.

Main Methods:

• Retrospective cohort study of patients undergoing primary one- or two-level TELD.
• PROMs assessed included Oswestry Disability Index (ODI), SF-12 PCS, and Visual Analog Scale (VAS) for back and leg pain.
• Data collected preoperatively and at 2 weeks, 6 weeks, 12 weeks, and 6 months post-surgery.

Main Results:

• Significant improvements in VAS back and leg pain were observed by 6 weeks, with a plateau thereafter.
• Oswestry Disability Index (ODI) and SF-12 Physical Component Score (PCS) showed significant improvement at 6 weeks, also reaching a plateau.
• High rates of return to activities were noted, with median return to driving at 8 days and work at 35 days.

Conclusions:

• The majority of postoperative improvement following TELD occurs within the initial 6 weeks.
• Patient-reported outcomes tend to plateau after 6 weeks, with sustained benefits at 6 months.
• TELD offers a less invasive option that may help patients avoid spinal fusion surgery.