Percutaneous lumbar discectomy failures — 5 key notes

Spine
Laura Dyrda -

A new study published in the Journal of Neurosurgery: Spine examines the risk factors for percutaneous endoscopic lumbar discectomy.
The study authors reviewed medical records for 350 patients with single-level lumbar disc herniation and found 36 patients who underwent reoperation due to endoscopic surgery failure. Here are five key notes from the study:

1. The patients' average visual analog scale pain scores and Oswestry Disability Index scores improved significantly at one month after surgery:

  • VAS: 6.6 to 1.9
  • ODI: 51.6 to 28.3


2. At one year after surgery, the patients reported a 1.2 VAS and 9.3 ODI on average.

3. The analgesic medication consumption decreased from 74.6 percent preoperatively to 19.7 percent at one month after surgery and 10 percent at one year postoperatively.

4. Older patients — 60 years or above — were more likely to experience procedure failure when compared with younger patients. There were also higher numbers of patients with diabetes in the failure group.

5. The outcomes improved as surgeons gained familiarity with the procedure; the failure rate in the early use was 17.1 percent through the first 70 cases. Failure rate fell to 5.7 percent in the midrange and eventually stabilized at 10 percent at procedures 211 to 280 and 281 to 350.

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