Percutaneous Endoscopic Lumbar Discectomy Vs Open Lumbar Microdiscectomy: A Comparison of Patient-Reported Outcomes in a Retrospective Cohort Follow-Up Design during the First Years of Implementation of Endoscopic Lumbar Discectomy

Author(s): Rune Mygind Mieritz, Baskaran Ketharanathan, Thomas von Bonsdorff, Søren Wacher Qvistgaard, Mogens Bach Pedersen, Hanne Dinesen, Mette K Schulz, Frantz R Poulsen

Background: The purpose of this study was to compare the patient-reported outcome of two different surgical techniques for lumbar disc herniation disease—percutaneous endoscopic lumbar transforaminal discectomy (PELD) versus open lumbar microdiscectomy (OLM)—in the first years of implementation of PELD in a clinical setting.

Methods: Fifty-one patients were included and stratified according to surgical treatment. Patient records were reviewed, and the patient-reported outcomes were assessed using the Oswestry Disability Index (ODI) and the EQ-5D-3L.

Results: OLM and PELD both significantly improved patient-reported outcomes for the patients. The OLM group had a significant larger improvement in ODI-score (p = 0.019) and EQ-5D-3L sum score, p = 0.009 compared to the PELD group. The OLM group was also the only group showing statistical significant improvement of EQ VAS-score (p < 0.001).

Conclusion: The results of the current study favors the OLM procedure over PELD in the first years of implementation of PELD in a clinical setting. Other studies list the advantages of PELD as minimal invasiveness, shorter time of operation and time of in hospital admission. The narrow population, study limitations and retrospective study design should be taken into consideration when interpreting these results, and hence randomized controlled trials are needed.

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