Our Summary

This study looked at the effectiveness of two types of surgical procedures for treating a condition called lumbar disc herniation (LDH), which is a problem with one of the discs between the vertebrae in the lower back. The two procedures are percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM).

The researchers analyzed past studies that compared PELD and OLM. They looked at 7 studies involving 1389 patients in total. They also considered several outcomes, such as the patients’ reported pain levels before and after surgery, their physical function after surgery, the rate of complications, and the rate of re-operations.

Their results showed that there was no significant difference between PELD and OLM in terms of pain levels, physical function, complication rate or reoperation rate. However, they found that the PELD procedure was associated with shorter operation time and hospital stay compared to the OLM procedure.

In other words, both procedures seem to be equally effective for treating LDH, but PELD might be a better choice for patients because it is quicker and requires a shorter hospital stay.

FAQs

  1. What are the two surgical procedures discussed in the study for treating lumbar disc herniation (LDH)?
  2. Was there any significant difference between the effectiveness of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) in the study?
  3. Why might PELD be a better choice for patients as per the study conclusion?

Doctor’s Tip

A doctor might advise a patient undergoing a discectomy to consider the percutaneous endoscopic lumbar discectomy (PELD) procedure over the open lumbar microdiscectomy (OLM) procedure, as it has been found to have similar effectiveness in treating lumbar disc herniation (LDH) but with shorter operation time and hospital stay.

Suitable For

Patients who are typically recommended for discectomy are those who have not found relief from conservative treatments such as physical therapy, medications, and injections for their lumbar disc herniation. They may be experiencing severe pain, weakness, numbness, or tingling in their lower back, buttocks, legs, or feet that is not improving with non-surgical options. Additionally, patients who have a large herniated disc that is pressing on a nerve and causing significant symptoms may also be good candidates for discectomy.

Timeline

Before the discectomy procedure, a patient may experience symptoms such as back pain, leg pain, numbness, or weakness in the lower back and legs. They may undergo diagnostic tests such as MRI or CT scans to confirm the diagnosis of lumbar disc herniation. They may also try conservative treatments such as physical therapy, medications, or injections to manage their symptoms.

After the discectomy procedure, the patient may experience immediate relief from their symptoms, although some pain and discomfort may persist initially as they recover from surgery. They will have to follow post-operative care instructions, such as avoiding heavy lifting and bending, and attending physical therapy sessions to regain strength and flexibility in the back. Over time, the patient should experience improvement in their pain levels and physical function, leading to a better quality of life.

What to Ask Your Doctor

Questions a patient should ask their doctor about discectomy include:

  1. What are the potential risks and complications associated with both percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM)?
  2. How long is the recovery time for each procedure, and what can I expect in terms of pain management and rehabilitation?
  3. Are there any specific criteria that make me a better candidate for one procedure over the other?
  4. What is the success rate of both procedures in terms of relieving pain and improving physical function?
  5. Are there any long-term implications or considerations I should be aware of after undergoing either procedure?
  6. How experienced are you in performing both PELD and OLM, and what is your success rate with each procedure?
  7. Will I need any additional follow-up appointments or treatments after the surgery?
  8. Are there any alternative treatment options that I should consider before deciding on surgery?
  9. How will you determine which procedure is the best option for me, and what factors will you consider in making that decision?
  10. Can you provide me with any additional information or resources to help me make an informed decision about my treatment options?

Reference

Authors: Ruan W, Feng F, Liu Z, Xie J, Cai L, Ping A. Journal: Int J Surg. 2016 Jul;31:86-92. doi: 10.1016/j.ijsu.2016.05.061. Epub 2016 May 31. PMID: 27260312