The following is a summary of “Endoscopic Revision Strategies and Outcomes for Recurrent L4/5 Disc Herniation After Percutaneous Endoscopic Transforaminal Discectomy,” published in the February 2024 issue of Pain by Lin et al.
Researchers conducted a retrospective study to examine endoscopic revision and surgical methodologies for L4/5 recurrent disc herniation (rLDH) after percutaneous endoscopic transforaminal discectomy (PETD).
They involved 96 patients who had undergone PETD for rL4/5 rLDH after PETD (January 2016- September 2022). Patients were divided into two categories based on the revision approach: a PETD group (57 cases) and the percutaneous endoscopic interlaminar discectomy (PEID) group (39 cases). Clinical outcomes were assessed by recording the Visual Analogue Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and modified MacNab standard.
The results showed no significant differences between the two groups’ demographic data and intraoperative blood loss (P>0.05). The PEID group demonstrated significantly shorter operation time and fewer intraoperative X-ray fluoroscopy exposures than the PETD group (P<0.05). Postoperatively, both groups exhibited gradual improvement in clinical indexes, with significant enhancements in VAS score, ODI index, and JOA score at the 1-week, 1-month, and 6-month follow-ups (P<0.05). No severe complications were observed during the follow-up period.
Investigators concluded that percutaneous endoscopic revision was successful for rLDH after PETD of L4/5 segments. PEID was potentially preferred due to shorter procedure times and reduced scarring, but specific herniation types may require tailored surgical plans.
