Short-Term Outcome Comparison Between Full-Endoscopic Interlaminar Approach and Open Minimally Invasive Microsurgical Technique for Treatment of Lumbar Disc Herniation.
OBJECTIVE
To compare postoperative pain control and functional outcome between full-endoscopic interlaminar approach (FEIA) and open minimally invasive microsurgical technique (MMST) for lumbar discectomy.


METHODS
All consecutive patients treated with FEIA were prospectively followed. Clinical outcome parameters (low back and leg numeric rating scale and Quebec Back Pain Disability Scale) were measured. Analgesics use after surgery was quantified. Results were compared with a cohort of patients treated in the same period with MMST. The decision regarding which surgical technique to use was based on endoscope availability only.


RESULTS
There were 26 patients treated with FEIA and 18 treated with MMST. Baseline patient characteristics were comparable. Sciatic pain was treated in both groups. Postoperative back pain was significantly lower in the FEIA group (numeric rating scale scores 1.5, 0.3, and 0.2 at 1, 2, and 4 weeks after FEIA vs. 3.6, 2.4, and 1.6 after MMST). In the FEIA group, 61.5% of patients did not take any pain medication. The average number of analgesics taken within 30 days was 4.0 in the FEIA group and 27.2 in the MMST group. The average Quebec Back Pain Disability Scale score decreased from 57.7 to 25.0, 18.0, and 14.2 at 1, 2, and 4 weeks after FEIA compared with a decrease from 58.8 to 41.1, 34.7, and 23.0 in the MMST group. No approach-related complications were reported.


CONCLUSIONS
With less analgesic use, back and leg pain relief after 1 week in the FEIA group was comparable to that achieved in the MMST group after 1 month. This was also true for overall ability of patients to perform daily activities.
['Casimiro|Miguel|M|']
D000328:Adult D000700:Analgesics D019299:Decompression, Surgical D017586:Diskectomy D005260:Female D006801:Humans D007405:Intervertebral Disc Displacement D017116:Low Back Pain D008159:Lumbar Vertebrae D008279:Magnetic Resonance Imaging D008297:Male D008866:Microsurgery D008875:Middle Aged D044583:Neuroendoscopy D019635:Neurosurgical Procedures D010149:Pain, Postoperative D016896:Treatment Outcome
Interlaminar approach Analgesics consume Endoscopic spine surgery Functional recovery after surgery Lumbar disc disease Lumbar spine surgery Microsurgical discectomy Minimally invasive surgery Postoperative pain analgesia Quebec back pain scale functional assessment Sciatic pain treatment Surgical outcome