Targeted percutaneous transforaminal endoscopic diskectomy in 295 patients: comparison with results of microscopic diskectomy.
BACKGROUND
The aim of this study is to compare the clinical outcomes and complications after targeted PTED and conventional microscopic diskectomy for removing 1-level unilateral LDH and to evaluate the efficacy of PTED for the treatment of LDH.


METHODS
The authors retrospectively examined 915 consecutive patients who underwent PTED (group A, 301 patients) and microscopic diskectomy (group B, 614 patients) for 1-level unilateral LDH. Patients who were treated with a diskectomy in the period from July 2003 to December 2004 were evaluated by telephone interview and institute visit. This assessment was performed at least 18 months (range, 18-36 months) after their operation. The follow-up rate in groups A and B was 97.5% (295 patients) and 96.5% (607 patients), respectively.


RESULTS
Good or excellent results were obtained in 84.7% and 85.0% of groups A and B (P = .92). The rates of recurrence were 6.44% and 6.75% in groups A and B (P > .05). Twenty-eight patients (14 cases of recurrence, 5 cases of incomplete removal, 5 cases of stenosis, 2 cases of diskogenic back pain, and 2 cases of diskitis) in group A and 38 patients (26 cases of recurrence, 6 cases of incomplete removal, 2 cases of stenosis, 2 cases of diskogenic back pain, 1 case of hematoma, and 1 case of diskitis) in group B underwent reoperation.


CONCLUSIONS
Based on our results, the PTED can be a reasonable alternative to a conventional microscopic diskectomy for the treatment of patients with LDH, except for those in downward far-migrating cases beneath the pedicle of the lower vertebra or in cases involving L5-S1 with a high pelvis.
Department of Neurosurgery, Bogang Spine Hospital, Daegu, Republic of Korea.
Myung-Jin
MJ
Kim
Department of Neurosurgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea. Electronic address: sobotta@dreamwiz.com.
Sun-Ho
SH
Lee
Department of Neurosurgery, Bogang Spine Hospital, Daegu, Republic of Korea.
Eul-Soo
ES
Jung
Department of Neurosurgery, Bogang Spine Hospital, Daegu, Republic of Korea.
Byong-Gil
BG
Son
Department of Neurosurgery, Bogang Spine Hospital, Daegu, Republic of Korea.
Eun-Seok
ES
Choi
Department of Neurosurgery, Bogang Spine Hospital, Daegu, Republic of Korea.
Jong-Hyun
JH
Shin
Department of Neurosurgery, Kyungpook National University, School of Medicine, Daegu, Republic of Korea.
Joo-Kyung
JK
Sung
Department of Neurosurgery, Bogang Spine Hospital, Daegu, Republic of Korea.
Yong-Chul
YC
Chi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017586:Diskectomy / Q000379:methods*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012447:Sacrum; D016896:Treatment Outcome