Clinical Outcomes of Percutaneous Full-Endoscopic Interlaminar Lumbar Discectomy (PFEILD): A Retrospective...

Introduction Low back pain (LBP) is a major health problem among adults, with lumbar disc herniation (LDH) being a common underlying cause. While many patients with LDH respond to conservative management, surgical intervention may be required in selected cases. Percutaneous full-endoscopic interlaminar lumbar discectomy (PFEILD) is a minimally invasive percutaneous endoscopic discectomy that offers several potential advantages, including reduced tissue disruption, shorter hospital stays, and faster postoperative recovery. However, few studies in our region have evaluated the clinical and functional outcomes of this technique. Methods A total of 25 patients who attended the spinal surgery unit at Dr. Soliman Fakeeh Hospital (DSFH) in Jeddah, Saudi Arabia, and underwent PFEILD between January 2019 and January 2023 were included. The study aimed to evaluate the outcomes of PFEILD in terms of length of hospital stay, time to return to work, postoperative complications, recurrence, and clinical and functional improvement. The patients were followed postoperatively for approximately 24-36 months. Clinical and functional outcomes were assessed using the MacNab criteria, the Visual Analog Scale (VAS) for leg pain, and the Oswestry Disability Index (ODI). Data were collected from the hospital electronic health record (EHR) and analyzed using IBM SPSS Statistics for Windows, Version 29 (Released 2022; IBM Corp., Armonk, New York, United States). Results Of the 25 patients, 68% (n=17) were discharged within one postoperative day, while 96% (n=24) experienced no postoperative complications. An excellent postoperative outcome according to the MacNab criteria was reported in 80% (n=20) of patients. Preoperatively, 92% (n=23) of participants had a VAS score for leg pain >5/10, compared with 96% (n=24) who had a postoperative VAS score <5/10. The difference between the preoperative and postoperative VAS scores was statistically significant (P<0.001). Furthermore, 72% (n=18) of patients had a preoperative ODI score >40, whereas none had a postoperative ODI score >40. The difference between preoperative and postoperative ODI scores was statistically significant (P<0.001). Conclusion Minimally invasive PFEILD demonstrated favorable clinical and functional outcomes, with significant improvements in leg pain and disability, short postoperative hospital stays, early return to work, and a low rate of complications. Further large-scale, prospective, multi-center studies are recommended to validate these findings and assess the long-term outcomes of this technique.