Percutaneous transforaminal endoscopic discectomy in the treatment of senior patients with lumbar degenerative disc disease

Bai,Jiayue; Zhang,Wei; Liu,Xiangzhou; Cheng,Jinghang; Wang,Xianzheng; Ding,Wenyuan; Shen,Yong

doi:10.3892/etm.2018.6996

Percutaneous transforaminal endoscopic discectomy in the treatment of senior patients with lumbar degenerative disc disease

Authors:
- Jiayue Bai
- Wei Zhang
- Xiangzhou Liu
- Jinghang Cheng
- Xianzheng Wang
- Wenyuan Ding
- Yong Shen
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Affiliations: Department of Orthopedics, The Third Hospital of Shijiazhuang Hebei Province, Shijiazhuang, Hebei 050051, P.R. China, Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Key Biomechanical Laboratory of Orthopedics, Shijiazhuang, Hebei 050051, P.R. China, Department of Orthopedics, The 251st Hospital of PLA, Zhangjiakou, Hebei 075000, P.R. China, Department of Orthopedics, Gaocheng People's Hospital, Shijiazhuang, Hebei 050000, P.R. China
Published online on: November 20, 2018 https://doi.org/10.3892/etm.2018.6996
Pages: 874-882

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Abstract

The aim of the current study was to analyze the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar degenerative disc disease for senior patients. The clinical and follow‑up data of senior patients were retrospectively reviewed. Patients were divided into a PTED group and an open surgery group. Parameters were analyzed, including surgery time, intraoperative fluoroscopy time, intraoperative blood loss, postoperative complications, visual analog scale (VAS) and Japan Orthopedic Association (JOA) scores. Compared with the open surgery group, the surgery time and intraoperative blood loss were decreased, while the intraoperative fluoroscopy time was increased, in the PTED group (P<0.001). Significant improvements in VAS and JOA scores were identified within both groups from preoperative to 12 months following surgery (P<0.001). VAS and JOA scores were significantly improved in the PTEN group compared with the open surgery group at 1 week after surgery (P<0.001), but there was no significant difference between groups prior to and at 12 months following surgery. The incidence of venous thrombosis of the lower extremities in the PTED group was decreased compared with the open surgery group (P<0.05). In the open surgery group, patients suffered from multiple postoperative complications, including constipation, urinary system infection, wound infection, gastrointestinal hemorrhagic stress ulcer, pneumonia, pulmonary embolism, mortality following myocardial infarction, mortality following cerebral infarction, and hemiplegia following cerebral hemorrhage. By contrast, patients in the PTED group did not experience any of these complications. In conclusion, PTED resulted in reduced trauma and a lower incidence of severe complications compared with open surgery, which suggests that PTED is a safe and effective minimally invasive surgery for senior patients with lumbar degenerative disc disease.

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