Trans-sacral epiduroscopic laser decompression versus the microscopic open interlaminar approach for L5-S1 disc herniation

초록

Context/Objective: Trans-sacral epiduroscopic laser decompression (SELD) is an alternative to microscopic open lumbar discectomy (OLD). SELD and OLD for L5-S1 lumbar disc herniation (LDH) have not been compared. We compared clinical results, including pain control, between SELD and OLD. Design: Retrospective analysis. Setting: Korean hospital. Participants: Eighty patients treated with SELD (n = 40) or microscopic OLD (n = 40) for L5-S1 LDH. Interventions: N/A. Outcome Measures: Clinical data were compared over 6 months. Functional status was evaluated using Oswestry Disability Index (ODI, 0-100%) and time to return to work. Preoperative and postoperative pain was measured using a visual analog scale (VAS, 0-10). Radiological assessment was performed preoperatively and postoperatively. Results: The ODI and VAS scores for leg and back pain significantly improved in both groups. At 6-months after the procedure, the average ODI decreased to 13.2 +/- 11.2 from 54.5 +/- 14.5 for SELD and 9.5 +/- 10.4 from 57.5 +/- 16.0 for OLD. The average leg VAS decreased to 1.9 +/- 1.2 from 6.0 +/- 1.4 for SELD and 2.3 +/- 1.3 from 6.7 +/- 1.6 for OLD. Back VAS reduced to 2.6 +/- 1.3 from 7.2 +/- 1.5 for OLD. Time to return to work was 1.1 +/- 1.1 weeks for SELD and 5.4 +/- 2.1 weeks for OLD. Clinical outcomes of SELD were non-inferior to those of OLD in terms of pain control. Conclusion: A scar-free procedure and early return to normal life are advantages of SELD.

키워드