Radiological Evaluation of Percutaneous Endoscopic Lumbar Discectomy: A Three-Year Follow-Up Study

ABSTRACT

PURPOSE: We wanted to analyze the radiological changes of the patients who underwent percutaneous endoscopic lumbar discectomy (PELD) for treating soft disc herniation. MATERIALS AND METHODS: We retrospectively reviewed 30 patients (32 cases) who were observed for a minimum of 3 years after they underwent PELD. The authors investigated the postoperative radiological changes after PELD and the related clinical outcomes. All the patients received plain X-rays, CT and MRI both preoperatively and at the final follow-up. The radiological parameters were evaluated, including the disc height, the disc signal intensity, the subchondral marrow signal intensity, the sagittal plane instability and the facet joint osteoarthritis. RESULTS: The average amount of removed disc was 1.363 g and a significant correlation was detected between the narrowing of disc height and the amount of removed disc. Although the disc height and the disc height ratio were significantly decreased (-0.97 mm and 86.9%, respectively), the angle of sagittal rotation was well maintained. There were 18 (56.3%) cases of disc signal changes, six cases (18.8%) of subchondral marrow signal changes, and three cases (9.4%) of facet joint osteoarthritis. The success rate was 90.6%. CONCLUSION: Although disc height narrowing was observed, there was no postoperative instability and the overall clinical outcome was satisfactory. Our results show that PELD is a useful and minimal invasive procedure for the selected patients who are suffering with lumbar disc herniation.