PELD Versus Full Laminectomy In The Treatment Of Cauda Equina Syndrome(CES)Caused By Lumbar Disc Herniation(LDH)

Objective:To compare the clinical efficacy of percutaneous endoscopic lumbar discectomy(PELD)and full laminectomy in the treatment of cauda equina syndrome(CES)caused by lumbar disc herniation(LDH).Methods:43 patients with CES either underwent PELD or laminectomy surgery between May 2015 to January 2017 and data was collected and retrospectively analyzed.The patients were divided into 2 groups according to the respective surgical methods that they underwent:the PELD group(with 21 patients,14 males and 7 females,and an average age of 42.67±9.70 years)and the laminectomy group(with 22 patients,16 males and 6 females,and an average age of 44.55±9.36 years).The modified JOA "leg-trunk-bladder" score was used to assess the efficacy of the respective surgical methods.Results:By comparing the duration of the surgical operation and the length of the hospital stay between the two groups,it can be concluded that the laminectomy group had a higher result than those in the PELD group,in both of the factors mentioned above.All the differences were statistically significant.The postoperative JOA scores of both groups obviously improved compared with those before operation,the differences were statistically significant.There were no significant differences in JOA scores between the two groups at pre-operation,6 months and lyear follow-up.There exist 1 patient each in both group who had their CES symptoms worsen after the operation,however immediate re-operation procedures ensured that the outcomes were satisfactory.Conclusion:The efficacy of PELD and laminectomy is comparable as a short to midterm treatment of CES at the early to middle stage caused by LDH.However,PELD is significantly better in reducing duration of surgery,hospitalization days and traumas when compared to laminectomy.