Percutaneous Endoscopic Lumbar Discectomy for the Treatment of Lumbar Disc Herniation— A Novel Approach

Abstract

Background: Lumbar disc herniation (LDH) is a prevalent condition causing significant morbidity and disability. Traditional open lumbar microdiscectomy (OLM) has been the gold standard for treatment, but percutaneous endoscopic lumbar discectomy (PELD) has emerged as a promising minimally invasive alternative.

Methods and materials: A cross-sectional analytical study was conducted at the Department of Neurosurgery, National Institute of Neuro Sciences & Hospital. Thirty-three patients with LDH at the L4/L5 level who underwent PELD were included. Preoperative and postoperative pain levels were measured using the Visual Analogue Scale (VAS), and functional disability was assessed using the Oswestry Disability Index (ODI).

Results: The mean age of participants was 42.21 ± 12.13 years. Postoperative outcomes showed the mean VAS scores for lower back pain decreased from 6.17±3.70 to 1.78±0.72, right lower leg pain from 6.55±3.50 to 1.79±0.76, and left lower leg pain from 6.51±3.22 to 1.75±0.55. The mean ODI score improved from 86.16±8.01 to 22.49±7.08. The improvement rates at 90th POD were 84.84% for lower back pain, 84.84% for right lower leg pain, 87.87% for left lower leg pain, and 93.93% for ODI. The mean hospital stay was 5.17±3.67 days, with a disc space infection rate of 3.03% .

Conclusion: PELD is a highly effective and safe alternative to OLM for treating LDH, offering significant pain relief and functional improvement with minimal complications. Further research with larger sample sizes and long-term follow-up is needed to validate these findings and refine patient selection criteria.