Short-term clinical efficacy of percutaneous transforaminal endoscopic discectomy in treating young patients with lumbar disc herniation

Abstract

Background: In the last decades, full-endoscopic techniques to treat lumbar disc herniation (LDH) have gained popularity in clinical practice. However, few studies have described the safety and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in treating younger patients with LDH. This study aims to evaluate the preliminary surgical outcome and complication of PTED in treating younger patients with LDH. Methods: Between June 2012 and June 2016, 72 young patients (<45 years old) who underwent PTED for single-level LDH were prospectively followed up. All patients were followed up for at least 12 months (range 12-35 months). Pain was measured using visual analogue scale (VAS) scores. Patient satisfaction was evaluated using the MacNab outcome scale. Clinical outcomes were measured preoperatively, at 2 days and 6 months, and 12 months postoperatively. Results: The mean VAS score for back pain was 5.1±2.3 preoperatively and 3.1±1.2, 2.1±0.5, and 2.0±0.7 at 2 days, 6 months, and 12 months postoperatively, respectively. The VAS score for leg pain was 7.1±2.6 preoperatively and 3.0±1.1, 2.1±1.3, and 1.9±0.8 at 2 days, 6 months, and 12 months postoperatively, respectively. These postoperative scores were all significantly different when compared with preoperative scores (P<0.001). According to the modified MacNab outcome scale, excellent was obtained in 43 patients, good was obtained in 25 patients, and fair was obtained in 4 patients, and 94.44% of these patients had excellent and good outcomes at the final follow-up. There were no complications related to surgery, and no spinal instability was detected. Conclusion: PTED appears to be an effective and safe intervention for younger patients with LDH. High-quality randomized controlled trials are required to further study the efficacy and safety of PTED in treating younger patients with LDH.