Comparison of Percutaneous Endoscopic Lumbar Diskectomy and Open Lumbar Microdiskectomy for Recurrent Lumbar Disk Herniation.

Objective To establish the appropriateness of transforaminal percutaneous endoscopic lumbar diskectomy (PELD) by comparing it with open lumbar microdiskectomy (OLM) for surgical treatment of recurrent lumbar disk herniation. Methods We retrospectively analyzed 83 patients who underwent revision surgery (group A: PELD, 35 cases; group B: OLM, 48 cases) for recurrent lumbar disk herniation between March 2009 and April 2014. All of the patients were followed > 12 months. To evaluate outcomes, we checked the leg and back visual analog scale (VAS), Oswestry Disability Index (ODI), complications, and recurrence for all patients. Results The mean improvement of VAS for leg was 5.97 +/- 0.98 for group A and 5.62 +/- 1.42 for group B (p = 0.194). The mean improvement of VAS for back pain was 2.71 +/- 1.30 for group A and 2.29 +/- 1.41 for group B (p = 0.168). The mean improvement of ODI scores was 28.86 +/- 3.93 for group A and 28.00 +/- 4.22 for group B (p = 0.350). Total surgery-related complications were none for group A and nine for group B (p = 0.009). Group A had one subject with surgery-related neurologic symptoms and group B had four (p = 0.391). Recurrence occurred in two patients in group A and seven patients in group B (p = 0.291). Conclusion PELD and OLM have favorable clinical outcomes in patients with recurrent lumbar disk herniation, and PELD results in fewer complications compared with OLM. Therefore, PELD may be a better alternative to OLM for patients with recurrent lumbar disk herniation.