Our Summary

This research paper looked at two types of minimally invasive surgery used to treat lumbar disc herniation (a common condition where a disc in the lower back herniates, causing pain and discomfort). The two types of surgery are percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID).

The researchers analyzed data from 26 different studies involving 3,294 patients. They found that PETD was more effective than PEID in reducing both short and long term pain, resulted in less blood loss, a shorter hospital stay, and a smaller surgical wound.

However, PEID had a slightly lower rate of the condition recurring and the operation was quicker. In terms of safety, patient satisfaction, disability scores and complication rates, both types of surgery were comparable.

Despite the slightly longer operating time, the researchers concluded that PETD is the better option for patients with lumbar disc herniation due to its other benefits.

FAQs

  1. What are the two types of minimally invasive surgery used to treat lumbar disc herniation discussed in the article?
  2. Between percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID), which one is more effective at reducing both short and long term pain?
  3. What advantages does PEID have over PETD according to the research?

Doctor’s Tip

A doctor may advise a patient undergoing a discectomy to consider opting for percutaneous endoscopic transforaminal discectomy (PETD) over percutaneous endoscopic interlaminar discectomy (PEID) due to its superior outcomes in reducing pain, shorter hospital stay, less blood loss, and smaller surgical wound. However, it is important to weigh the benefits and risks of each procedure and discuss with your doctor to determine the best option for your specific condition.

Suitable For

Patients who are typically recommended for discectomy are those who have not found relief from conservative treatments such as physical therapy, medication, and injections. These patients may have severe and persistent pain, weakness, numbness, or tingling in the legs, as well as difficulty walking or performing daily activities. Additionally, patients who have a lumbar disc herniation that is causing compression on the nerves in the lower back may be good candidates for discectomy. It is important to consult with a healthcare provider to determine the best treatment option for each individual case.

Timeline

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

After the discectomy procedure, the patient may experience immediate relief from their symptoms as the pressure on the nerves is relieved. They may need to stay in the hospital for a short period of time for monitoring and pain management. They will need to follow post-operative instructions such as avoiding heavy lifting, bending, and twisting for a certain period of time. Physical therapy may be recommended to help strengthen the muscles in the back and prevent future injuries. Over time, the patient should experience a gradual improvement in their symptoms and a return to their normal activities.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with a discectomy procedure?
  2. How long is the recovery time after a discectomy surgery?
  3. What type of physical therapy or rehabilitation will be necessary after the surgery?
  4. How likely is it that the herniated disc will reoccur after the surgery?
  5. What are the long-term outcomes and success rates of the different types of minimally invasive discectomy surgeries?
  6. Are there any alternative treatment options to consider before opting for surgery?
  7. Will the surgery be performed by a specialized spine surgeon with experience in minimally invasive techniques?
  8. What can I do to optimize my chances of a successful outcome following the surgery?
  9. How soon after the surgery can I expect to see improvement in my symptoms?
  10. What post-operative care instructions should I follow to aid in my recovery process?

Reference

Authors: Chen P, Hu Y, Li Z. Journal: Biosci Rep. 2019 Feb 15;39(2):BSR20181866. doi: 10.1042/BSR20181866. Print 2019 Feb 28. PMID: 30705086