Percutaneous Endoscopic Lumber Discectomy Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Disc Herniation:a Prospective Randomized Controlled Study / 中国微创外科杂志

ABSTRACT

Objective To compare clinical outcomes of percutaneous endoscopic lumber discectomy ( PELD ) versus minimally invasive transforaminal lumbar interbody fusion ( Mis-TLIF ) under the Quadrant system in the treatment of lumbar disc herniation. Methods From January 2010 to December 2013, 60 patients with lumbar disc herniation and failed to conservative treatment were enrolled in this study.According to the random number table, the patients were divided into two groups, with 30 patients in each group.There were no significant differences in age, gender, segment of disease, clinical diagnosis, and imaging results between the two groups (P >0.05).The surgery of PELD under the TESSYS endoscopic system or Mis-TLIF under the Quadrant system was performed by a same surgical team.Follow-up was conducted for 12-24 months (mean, 16.2 months).The operation time, blood loss, hospital stay, visual analogue scores (VAS) for back and leg pain, Oswestry disability index (ODI), Japanese Orthopaedic Association ( JOA ) scores, MacNab criteria, and complications were compared between the two groups. Results As compared with the Mis-TLIF group, the PELD group had significantly shorter operation time [(72.0 ±18.7) min vs. (137.0 ±48.3) min, t=-6.857, P=0.000], less intraoperative blood loss [(28.0 ±14.7) ml vs.(314.0 ±13.6) ml, t=-11.831, P=0.000], and shorter hospitalization stay [(4.0 ±1.0) d vs.(10.0 ±3.0) d, t=-9.298, P=0.000].The scores of VAS of back and leg pain at 2 weeks and 3 months postoperation in the PELD group was lower than the Mis-TLIF group (P0.05).There wasno significant difference in complication rate between the two groups. Conclusions Both PELD and Mis-TLIF are safe and effective for lumbar disc herniation.PELD has smaller incision, shorter operation time, and less blood loss as compared with Mis-TLIF.