Evaluation of percutaneous endoscopic lumbar discectomy: a prospective case series

Introduction Lumbar discectomy is one of the most common operations performed worldwide for lumbar‑related symptoms. During the latter half of the 19th century, more techniques were developed to remove the herniated disc with minimal invasiveness. The first herniated disc excision using a microscope (microdiscectomy) was performed by Yasargil in 1977. In 1993, Mayer and Brock and then, in 1997, Smith and Foley described endoscopic discectomy techniques. With these minimally invasive techniques, the authors demonstrated decreased soft tissue manipulation, operative time, blood loss, and hospital stay, allowing early recovery. Objective The objective of this study was to evaluate clinical, functional, and surgical outcomes of percutaneous endoscopic lumbar discectomy (PELD) in patients with lumbar disc herniation (LDH). Patients and methods This study is a clinical prospective case series conducted from December 2016 to May 2018; 15 patients who presented with single‑level, posterolateral, L4‑5 or L5‑S1 LDHs underwent PELD within a mean follow‑up period of 10.6 months. The procedure was evaluated by the duration of the procedure, blood loss, time of hospital stay, preoperative and postoperative visual analog score (VAS) of low back pain (LBP) and radicular pain (RP) and patient satisfaction according to modified MacNab’s criteria. Results There were 10 male patients and five female patients with the mean age of 35.9 years. The mean amount of intraoperative bleeding was 98.67 ml. The mean operative time was 124 min. The mean postoperative hospital stay was 33.6 h. The mean preoperative VAS of LBP was 6.13 and that of RP was 6.73. Postoperatively, the mean VAS of LBP became 1.6 and that of RP was 1.6. Patient satisfaction score according to modified MacNab’s criteria was excellent in 80% and good in 20%. Conclusion PELD appears to be an effective intervention for LDH, as it has a small amount of intraoperative blood loss, short postoperative hospital stay, and good clinical and functional outcomes. It needs more training, as it has a long learning curve.