Clinical Results of Percutaneous Endoscopic Lumbar Discectomy in Patients with Lumbar Disc Herniation: A Consecutive Prospective Study
Narongsak Bamrungthin MD1, Sitti Chaiyabut MD1, Aungkana Pornprapai MS2, Veerapan Kuonsongtum MD3
Affiliation : 1 Department of Orthopedics, Chaiyaphum Hospital, Chaiyaphum, Thailand 2 Department of Physical Therapy, Chaiyaphum Hospital, Chaiyaphum, Thailand 3 Bumrungrad Spine Institute, Bumrungrad International Hospital, Bangkok, Thailand
Objective : The objective was to evaluate clinical outcomes and complications of post percutaneous endoscopic lumbar
discectomy [PELD] in patients with lumbar disc herniation.
Materials and Methods : One hundred and one patients with lumbar disc herniation who underwent PELD between October
2013 and February 2017 were included in the present study. The Visual analog scale [VAS] at rest and during activity, the Thai
version of the modified Oswestry Disability Index [ODI] and complications were recorded preoperatively and 1 day, 2
months, 6 and 12 months postoperatively. Repeated measures ANOVA was used to compare the mean of clinical outcomes.
Results : Postoperative resting VAS and activity VAS declined clinically and statistically significant (p = 0.001). The Oswestry
Disability Index score increased significantly (p = 0.001). Of the 101 patients, 8 patients (7.92%) had revision surgery. Of
those, 4 cases (3.96%) were due to recurrence of lumbar disc herniation and 4 case (3.96%) were due to spinal instability.
Eleven patients (10.89%) still had leg pain, 15 patients (14.85%) had paresthesia, and 15 patients (14.85%) had a slight
motor deficit which completely disappeared during the follow-up period.
Conclusion : PELD is a safe and effective minimally invasive spine surgery technique. However, this technique has a steep
learning curve. In addition to selection of appropriate patients, successful surgery depends on high levels of surgical skills and
expertise.
Keywords : Percutaneous endoscopic lumbar discectomy, Minimal invasive spine surgery, Lumbar disc herniation, PELD
