Journal of Pain Research (Sep 2022)

Risk Factors Involved in the Early and Medium-Term Poor Outcomes of Percutaneous Endoscopic Transforaminal Discectomy: A Single-Center Experience

  • Wu H,
  • Hu S,
  • Liu J,
  • He D,
  • Chen Q,
  • Cheng X

Journal volume & issue
Vol. Volume 15
pp. 2927 – 2938

Abstract

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Hui Wu, Shen Hu, Jiahao Liu, Dingwen He, Qi Chen, Xigao Cheng Department of Orthopaedics, the Second Affiliated Hospital of Nanchang University, Nanchang city, Jiangxi Province, 330006, People’s Republic of ChinaCorrespondence: Xigao Cheng, Department of Orthopaedics, the Second Affiliated Hospital of Nanchang University, Nanchang city, Jiangxi Province, 330006, People’s Republic of China, Email [email protected]: To investigate the risk factors involved in the early and medium-term poor outcomes of percutaneous endoscopic transforaminal discectomy (PETD) treatment of lumbar disc herniation (LDH) at the L4-5 level.Methods: Between January 2015 and May 2020, we recruited 148 LDH patients at the L4-5 level who underwent PETD surgery. The patients were divided into Groups A and B, according to the surgical outcomes. Good and excellent outcomes were categorized into Group A, and generally good and poor outcomes were categorized into Group B. Clinical parameters (age, gender, symptom duration, hospital stay, operation time, blood loss, straight-leg raising (SLR), visual analog scale (VAS), Oswestry Disability Index (ODI) score and modified MacNab criteria) and radiologic parameters (foraminal height (FH), intervertebral height index (IHI), intervertebral angle (IVA), sagittal range of motion (sROM), and lumbar lordosis (LL)) were collected and analyzed using univariate and multiple logistic regression analyses.Results: At the 6-month follow-up post operation, univariate analysis revealed that the symptom duration, SLR, IHI, and sROM were strongly associated with poor outcomes. However, multiple logistic regression analysis demonstrated that prolonged symptom duration, large SLR angel, and large sROM were independent risk factors for poor outcomes. At the 2-year follow-up post operation, univariate analysis suggested that advanced age, prolonged symptom duration, large preoperative VAS score, small FH, small IHI, and large sROM were potential risk factors for poor outcomes. However, multiple logistic regression analysis demonstrated that prolonged symptom duration, small IHI, and large sROM were independent risk factors for poor outcomes.Conclusion: Our study demonstrated that prolonged symptom duration, large SLR angel, and large sROM were independent risk factors for poor outcomes immediately following PETD at the L4-5 level. However, prolonged symptom duration, small IHI, and large sROM were independent risk factors for poor outcomes at medium-term post PETD at the L4-5 level.Keywords: percutaneous endoscopic transforaminal discectomy, risk factors, lumbar disc herniation, early and medium-term, surgical outcomes

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