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Updated: Jun 4, 2026
A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
Percutaneous Endoscopic Lumbar Discectomy Serves as a Valuable Minimally Invasive Surgical Option for Adolescent
Bolu Zhang1, Qingshuang Zhou1, Chao Zhong2
1Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China.
Objective:
To compare perioperative outcomes, mid-term clinical efficacy, and sciatic scoliosis correction after percutaneous endoscopic lumbar discectomy (PELD) versus mini-open fenestration discectomy (MOFD) for adolescent lumbar disc herniation (ALDH).
Methods:
This retrospective cohort study reviewed 174 patients aged ≤ 21 years who underwent single-level L4/5 or L5/S1 discectomy between January 2021 and December 2024. Patients were grouped by procedure: PELD (n=83; TELD 44, IELD 39) or MOFD (n=91). Perioperative outcomes, VAS, ODI, EQ-5D, modified MacNab results, complications, recurrence, and radiographic correction of sciatic scoliosis were compared.
Results:
Baseline characteristics were comparable between groups. Compared with MOFD, PELD had a smaller incision (0.9±0.3 vs 3.7±0.7 cm; p<0.001), lower blood loss (13.6±12.1 vs 48.2±51.5 mL; p<0.001), no postoperative drainage, and shorter postoperative hospital stay (2.7±1.0 vs 4.5±1.6 days; all P<0.001). Operative time did not differ significantly. Both groups showed sustained improvement in VAS, ODI, and EQ-5D. The only between-group clinical difference was lower VAS back pain on postoperative day 1 after PELD, which did not persist. Excellent/good MacNab outcomes were similar (94.0% vs 94.5%). Same-level recurrence occurred in 3.6% and 2.2%, respectively. Among 63 patients with sciatic scoliosis, both procedures achieved comparable Cobb angle and AVT correction, with satisfactory radiographic and clinical correction in 95.2%.
Conclusion:
In this retrospective cohort, PELD provided less surgical trauma and faster early recovery than MOFD while achieving comparable mid-term functional outcomes and sciatic scoliosis correction. These findings support PELD as a valuable minimally invasive option for ALDH patients.
