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Journal of Korean Neurosurgical Society 2006;39(6): 413-418.
The Clinical Comparison between Open Surgery and Percutaneous Endoscopic Lumbar Discectomy in Extraforaminal Lumbar Disc Herniation.
Jin Seok Jeong, Sang Ho Lee, Sang Jin Lee, Byeong Wook Hwang
Department of Neurosurgery, Wooridul Spine Hospital, Busan, Korea. busan@wooridul.co.kr
ABSTRACT
OBJECTIVE
The objective of this study is to evaluate and compare the clinical results between classical open surgery and percutaneous endoscopic lumbar discectomy(PELD) in cases of extraforaminal lumbar disc herniation.
METHODS
We obtained the clinical data from 47 patients with extraforaminal lumbar disc herniations who underwent the open paramedian muscle-splitting approach or percutaneous endoscopic lumbar discectomy(PELD) between January 2001 and February 2004. This study consisted of patients with soft disc extraforaminal herniations. The patients were assessed with the visual analogue scale(VAS) and MacNab's criteria before surgery, just before discharge, and postoperative 1 year.
RESULTS
There were 25 cases in the open surgery group and 22 cases in the PELD group. The average operating time was 78+/-36.71 min in the PELD group and 110+/-29.68 min in the open surgery group. The mean hospital stay was 2.73+/-2.62 days in the PELD group and 7.68+/-2.59 days in the open surgery group. VAS decreased from 8.34+/-0.66 to 1.29+/-2.27 in the PELD group and from 8.40+/-1.40 to 1.70+/-1.72 in the open surgery group at the one-year follow-up. The success rate of PELD was 86.4%, compared with 80.0% for open surgery. However, there were no statistically significant difference between two groups for success rate and VAS.
CONCLUSION
Although the success rates were similar in both groups, PELD is less invasive, faster, and safe procedure than open surgery for extraforaminal disc herniation in selected patients.
Key Words: Percutaneous endoscopic lumbar discectomy; Open lumbar microdiscectomy; Foraminal; Extraforaminal; Disc herniation
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