Outcome of Percutaneous Transforaminal Endoscopic Lumbar Surgery in >60-Year-Old Patients with Low Back Pain

Singh, Ratish; Xin, Gao Zeng; Hirachan, Mangal Prasad; Cheng, Lin Yu

Abstract

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the outcome of percutaneous transforaminal endoscopic lumbar surgery (PTELS) and to evaluate the efficacy of this technique in the treatment of lumbar disc herniation (LDH) and lumbar spine stenosis (LSS) in >60-year-old patients. OVERVIEW OF LITERATURE: There has been number of studies done in aspect of PTELS. All those studies focused on overall clinical aspect with no any age specific analysis. This articles deals with the patient >60 years old with low back pain (LBP) treated with the PTELS. This study provides the details of clinical outcome after the surgery in those age group.
METHODS
We retrospectively studied 77 patients aged >60 years; out of these, 45 patients presented with LDH and 22 patients with lumbar spinal stenosis who underwent PTELS.
RESULTS
The mean age of the patients who underwent the surgery was 68.33±6.97 years and the mean duration of the surgery and the postoperative duration of hospitalization were 87.31±24.746 minutes and 79±2.711 days, respectively. The pre- and postoperative Oswestry Disability Index were 52.8022±11.98299 and 16.3513±12.97398 (p<0.05), respectively, indicating statistical significance. The pre- and postoperative visual analogue scale scores of the leg and back were 6.27±1.213 and 4.79±1.162 (p<0.05) and 1.40±1.688 and 1.30±1.436, respectively (p<0.05), which showed a significant difference. Based on the MacNab criteria, 76.1%, 10%, and 6% of the patients showed excellent or good, fair, and poor outcomes, respectively. Incomplete removal of content and reherniation were observed in 3% and 7.5% of the patients. No significant difference was found between the clinical outcomes of PTELS between LDH and LSS.
CONCLUSIONS
PTELS can be a good technique in spine surgery to relieve symptoms for LBP with satisfactory outcome, short duration of hospitalization, and advantages such as elimination of general anesthesia in elderly patients.