Volume 26, Issue 130, December 2022

Clinical outcome of patients after endoscopic discectomy performed by two specialists

Rapcan Robert^1,2,3, Kocan Ladislav^4,5, Burianek Miroslav¹, Rapcanova Simona³, Mlaka Juraj⁵, Matias Michal¹, Gajdos Miroslav⁶, Kocanova Hana⁷, Vaskovs Janka^8♦

¹Europainclinics, Starochodovska 1750, 149 00 Prague 4, Czech Republic
²Europainclinics, Kominarska 21/5, 831 04 Bratislava- Nove mesto, Slovak Republic
³Europainclinics, Na hradbach 3683/3, 085 01 Bardejov, Slovak Republic
⁴Clinic of Anesthesiology and Intensive Care Medicine, East Slovak Institute of Cardiovascular Disease, Ondavska 8, 040 11 Kosice, Slovak Republic
⁵Europainclinics, Clinic Terasa, Toryska 1, 040 11 Kosice, Slovak Republic
⁶Department of Neurosurgery, Faculty of Medicine, PavolJozefsafarik University in Kosice and Louis Pasteur University Hospital, Trieda SNP 1, 040 66 Kosice, Slovak Republic
⁷Clinic of Anesthesiology and Intensive Care Medicine, Railway Hospital and Clinic Kosice
⁸Department of Medical and Clinical Biochemistry, Faculty of Medicine, PavolJozefsafarik University in Kosice, Trieda SNP 1, 04066 Kosice, Slovak Republic

^♦Corresponding author
Department of Medical and Clinical Biochemistry, Faculty of Medicine, PavolJozefsafarik University in Kosice, Trieda SNP 1, 04066 Kosice, Slovak Republic

ABSTRACT

Background: Endoscopic lumbar discectomy (ELD) is a percutaneous minimally invasive procedure used in the treatment of lumbar disc herniation. The study (NCT02742311 ClinicalTrials.gov) compares clinical outcomes after the interventional pain physician (IPP) and spine surgeon (SPS) provided transformational discectomy. Methods: Subjects were followed for 12 months via planned examinations by pain physicians. Leg pain and back pain intensity was assessed by an 11-point numerical rating scale (NRS). Patient's functional disability was assessed by the Oswestry Disability Index (ODI). Reoperations between both physicians were calculated by relative risk (RR). Results: Study subjects showed a significant decrease in ODI scores in both groups (p<0.001). The mean ODI in the IPP-group was 41.1 ± 16.4 and in the SPS-group 38.9 ±16.3 preoperatively. Postoperatively it was 16.3 ±11.5 in the IPP-group and 15.9 ±14.3 in the SPS-group. Significantly lower pain scores for leg pain (p<0.001) and back pain (p<0.001) were also recorded at the 12-month follow-up. RR for re-herniation was 1.19 with 95% CI (0.33 to 4.26, p>0.05). Conclusion: We did not discover any significant difference between groups in the clinical outcomes during the 12-months evaluation. There was no significant difference in re-herniation rate in groups. Overall percentage of disc re-herniation was 5.26%.

Keywords: Back pain, disc herniation, endoscopic discectomy, functional disability, leg pain

Medical Science, 2022, 26, ms540e2621

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DOI: https://doi.org/10.54905/disssi/v26i130/ms540e2621

Published: 19 December 2022