Clinical Outcome Of Percutaneous Transforaminal Endoscopic Lumbar Surgery(PTELS) In Treatment Of Low Back Pain In Patients Over 60 Years Old

Background:Percutaneous transforaminal endoscopic lumbar surgery is the latest advance minimal invasive surgical technique in treatment of low back pain.Objective:To evaluate the clinical outcome of percutaneous transforaminal endoscopic lumbar surgery in elder patient above 60 years and also to observe the efficacy of this technique in lumbar disc herniation and lumbar spine stenosis in these age group patients.Materials and Methods:Total 77 patients all above 60 years age were retrospectively studied,among which 45 patients presented with Lumbar Disc herniation(LDH)and 22 patients with lumbar spinal stenosis(LSS)who had undergone Percutaneous Transforaminal Endoscopic Lumbar surgery(PTELS)in our hospital from 2013-6 to 2016-6.The mean follow up of 20.87 months was done.Results:Mean age of operated patient was 68.33 year.Average time of operation was 87.31±24.746 minutes.And average hospital stay after operation was 4.79±2.711 days.The pre and postoperative ODI was(52.8022±11.98299,16.3513±12.97398,p=0.000)with indicating statistically significance.The VAS of leg and back was(6.27±1.213,4.79±1.162 and 1.40±1.688,1.30±1.436)p=0.00,p=0.00 respectively with significant difference before and after surgery.76.1%of patient shows excellent or good,10 fair and 6 poor outcomes on basis of MacNab criteria.3%(2 cases)of incomplete removal of content and 7.5%(5 cases)reherniation was found.In LDH there were total 45 patients.26 male and 19 female.In LSS.8 male and 14 female with total 22 patients.Time of operation in two group was 87.67±25.486 and 86.59±23.724 minute respectively with p=0.537 which showed no significance difference between two group.Hospital stay after surgery was 5.09+3.088 and 4.18+1.593 days respectively with p=0.484.There was no statistically clinical significance difference found between LDH and LSS on basis of ODI p=0.863,VAS leg and back p=0.193,p=0.897,MacNab criteria p =0.090.Conclusion:Percutaneous transforaminal endoscopic lumbar surgery(PTELS)can be a good alternative technique in spine surgery to relieve symptoms for low back pain with satisfactory outcome and low complication rate,short hospital stay and the advantage of no need of general anesthesia for elder patient.This technique also shows a good effect in lumbar spine stenosis in compare to lumbar disc herniation.