Study Design: Prospective study
Objective: To determine the clinical outcomes and the effect on quality of life of patients with endoscopic discectomy.
Summary of Background Data: Percutaneous endoscopic discectomy is a relatively new technique. Very few studies have reported the clinical outcome of percutaneous endoscopic discectomy in terms of quality of life and return to the work.
Method: Fifty-five patients with percutaneous endoscopic discectomy performed from the year 2002 to 2006 had their clinical outcomes reviewed in terms of the North American Spine Score (NASS), Medical Outcomes Study Short Form-36 (SF-36) scores and Pain Visual Analog Scale (VAS) and return to the work.
Results: The mean age was 35.6 years, the mean operative time was 60 minutes and the mean length of follow-up was 3 years. The mean hospital stay for endoscopic discectomy was 17 hours. There was statistical difference in the reduction of severity of back pain and lower-limb symptoms (NASS and VAS, P<0.05) at 6 months and 2 years. There was significant improvement in all aspects of the quality of life (SF-36, P<0.05) scores except for general health at 6 months and 2 years postoperation. The improvement in the SF-36 quality of life parameters correlated with the improvement in the NASS back disability and neurogenic symptoms and the VAS leg and back pain scores. The recurrence rate was 5% (3 patients). The 5% patients (3 patients) subsequently underwent lumbar fusion for persistent back pain. All patients returned to their previous occupation after surgery at a mean time of 24 days.
Conclusions: Endoscopic discectomy is associated with improvement in back pain and lower-limb symptoms postoperation which translates to improvement in quality of life. It has the advantage that it can be performed on a day case basis with shorter length of hospitalization and early return to work thus improving quality of life earlier.
Department of Orthopedic Surgery, Singapore General Hospital, Singapore
No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Reprints: Chan Wearn Benedict Peng, MD, Department of Orthopedic Surgery, Singapore General Hospital, Outram Road, Singapore 169608 (e-mail: firstname.lastname@example.org).
Received for publication March 13, 2009
accepted June 17, 2009