Long-term Follow-up Results of Percutaneous Endoscopic Lumbar Discectomy.

BACKGROUND Open lumbar microdiscectomy (OLM) has been considered the gold standard in the management of lumbar disc herniation (LDH) for its favorable outcomes in long-term follow-up. Nowadays, percutaneous endoscopic lumbar discectomy (PELD) is gaining recognition. However, greatest limitation of studies of PELD is the lack of long-term follow-up outcomes. OBJECTIVE To investigate the long-term outcomes of PELD in terms of clinical and radiographic findings and revision surgery rate. STUDY DESIGN Retrospective study. SETTING Spine hospital. METHODS Sixty-two patients who underwent PELD 10 years previously were contacted for follow-up. Clinical parameters such as the visual analog scale scores for the back and legs (VAS-B and VAS-L, respectively), the Oswestry disability index (ODI), and radiographic findings such as the disc-height ratio and change in the difference between flexion and extension were recorded and compared to the preoperative values. RESULTS For 62 followed patients, 38 met our inclusion criteria (35 transforaminal, 3 interlaminar). Excluded were 6 patients (9.4%) who underwent revision OLM at same level and 17 patients (26.6%) who underwent lumbar spine surgery at other levels. The average follow-up period was 11.22 (± 0.83) years. For the remaining 38 patients who had no further surgery, the postoperative VAS-B (2.53 ± 1.98), VAS-L (1.82 ± 1.92), and ODI (12.69 ± 11.26) were significantly different from the pre-operative values (8.45 ± 1.52, 7.40 ± 3.04, and 55.33 ± 24.63, respectively; all P = 0.01). The average disc-height ratio was 81.54% of the original disc height. There was no evidence of instability after long-term postoperative follow-up. LIMITATION Retrospective nature of data collection. CONCLUSION PELD has favorable long-term outcomes.Key words: Long-term, PELD, endoscopic lumbar discectomy, revision rate, disc height, instability.