Modiﬁed Percutaneous Endoscopic Interlaminar Discectomy through the Near-spinous Process Approach for L4/5 Disc Herniation: A Retrospective Clinical Study

Orthopaedic Surgery, 2024 · DOI: 10.1111/os.14031 · Published: May 1, 2024

Simple Explanation

This study compares two minimally invasive surgical techniques for treating L4/5 lumbar disc herniation (LDH): modified percutaneous endoscopic interlaminar discectomy (MPEID) and percutaneous endoscopic transforaminal discectomy (PETD). MPEID is a new technique designed to improve short-term postoperative outcomes and reduce fluoroscopy time during surgery. The study involved 34 patients with L4/5 LDH who were treated with either MPEID or PETD. The researchers compared the operative time, fluoroscopy occurrences, and surgical outcomes of the two procedures. The results showed that MPEID had shorter operative times and fewer fluoroscopy occurrences compared to PETD. Both procedures were effective in improving patients' pain and disability scores, with no major complications reported.

Study Duration

June 2020 to June 2021

Participants

34 L4/5 LDH patients (17 MPEID, 17 PETD)

Evidence Level

Not specified

Key Findings

1
MPEID showed shorter operative times compared to PETD (65.41 vs 91.65 minutes, p < 0.001).
2
MPEID required fewer fluoroscopy occurrences compared to PETD (6.47 vs 9.71 times, p < 0.001).
3
Both MPEID and PETD significantly improved VAS-back, VAS-leg, and ODI scores at 12 months follow-up (p < 0.001).

Research Summary

This retrospective study compared the clinical efficacy of modified percutaneous endoscopic interlaminar discectomy (MPEID) with percutaneous endoscopic transforaminal discectomy (PETD) in treating L4/5 lumbar disc herniation (LDH). The results indicated that MPEID had shorter operative times and fewer fluoroscopy occurrences compared to PETD, while both techniques effectively improved clinical outcomes. The authors concluded that MPEID is a viable alternative to PETD for L4/5 disc herniation treatment, especially when specific surgical indications are met.

Practical Implications

Reduced Radiation Exposure

MPEID's lower fluoroscopy usage translates to reduced radiation exposure for both the patient and the surgical team.

Shorter Surgical Time

The shorter operative time of MPEID may lead to reduced anesthesia time and potentially faster patient recovery.

Alternative Surgical Option

MPEID provides surgeons with another effective option for treating L4/5 LDH, particularly in cases where PETD may not be ideal.

Study Limitations

1
Limited to a single center, resulting in a relatively small sample size.
2
The follow-up period was brief.
3
Further multi-center, prospective studies involving a larger cohort of patients and extended follow-up durations are necessary

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