Introduction: Open lumbar microdiscectomy (OLM) has been considered the gold standards in the management of lumbar disc herniation (LDH) for their favorable outcomes in long-term follow-up. Nowadays, percutaneous endoscopic lumbar discectomy (PELD) is gaining recognition. However, greatest limitation is the lack of long-term follow-up outcomes.
Methods: Sixty two patients who underwent PELD 10 years previously were contacted for follow-up. Clinical parameters such as the visual analog scales for the back and legs (VAS-B and VAS-L, respectively) the Oswestry disability index (ODI), and radiographic findings such as the disc-height ratio and change in the difference between flexion and extension were recorded and compared to the preoperative values.
Results: For 62 followed patients, 38 met our inclusion criteria (35 transforaminal, 3 interlaminar). Excluded were, 6 patients(9.4%) who underwent revision open lumbar microdiscectomy at same level and 17 patients(26.6%) who underwent lumbar spine surgery at other levels. The average follow-up period was 11.22 (±0.83) years. For the remaining 38 patients who had no further surgery, the postoperative VAS-Back (2.53 ± 1.98), VAS-Leg (1.82 ± 1.92), and ODI (12.69 ± 11.26) were significantly different from the pre-operative values (8.45 ±1.52, 7.40 ± 3.04, and 55.33 ± 24.63, respectively; all p = 0.01). The average disc-height ratio was 81.54% of the original disc height. There was no evidence of instability after long-term postoperative follow-up.
Conclusions: PELD has favorable long-term outcomes.
Patient Care: Participant can explain to patients about outcome of PELD with its long term revision rate.
Learning Objectives: By conlcusion of this session, participants should be able to identify the long-term outcomes of PELD in terms of clinical, radiographic findings and long term natural course with revision surgery rate.