Clinical Outcome Of Percutaneous Transforaminal Endoscopic Lumbar Surgery For The Treatment Of Lumbar Disc Herniation And Lumbar Spine Stenosis

Background: Lumbar Disc Herniation and Lumbar Spine Stenosis are the most common age related spine disease.Percutaneous Transforaminal Endoscopic Lumbar Surgery is the latest advance minimal invasive surgical technique to treat them.Objective: To evaluate the clinical outcome of Percutaneous Transforaminal Endoscopic Lumbar Surgery in patient with low back pain and also to observe the efficacy of this technique regarding age,sex and diagnosis.Materials and Methods: Total 257 patients were retrospectively studied,among which 153 patients presented were male and 104 were female,151 patients were ? 55 years of age and 106 patients were > 55 years of age,and 206 patients with Lumbar Disc Herniation and 51 patients with Lumbar Spine stenosis who had undergone Percutaneous Transforaminal Endoscopic Lumbar surgery(PTELS)in our hospital from 2013 to 2017.The mean follow-up of 19.78 months was done.Results: Overall average time of operation was 80.12±23.91 minutes and average hospital stay after operation was 4.33±1.94 days.The pre and postoperative ODI was(56.28±15.23,8.94±11.06,p<0.05)which showed statistically significance.The pre and postoperative VAS of leg and back was(6.70±1.15,5.83±1.44 and 0.83±1.30,0.73±1.18)p<0.05,p<0.05 respectively with significant difference before and after surgery.Overall 79.4 % of patient shows excellent or good,14% fair and 6.6% poor outcomes on basis of MacNab's criteria.Comparative analysis of the male and female patients regarding duration of surgery,hospital stay,VAS leg,VAS back,ODI result showed there was no statistically significant difference among the male and female population(p>0.05).Secondly,Comparative analysis of the lumbar disc herniation and Lumbar Spine Stenosis patients no statistically significant difference in days of hospital among(p>0.05).While statistically significant difference among the LDH and LSS population when evaluated for Preoperative VAS leg,VAS back and ODI Scores;Postoperative VAS leg,VAS back and ODI Scores and duration of surgery(p<0.05).Finally,Comparative analysis of the ?55 years old and(29)55 years old age groups showed there was statistically significant when evaluated for Preoperative VAS leg,VAS back and ODI Scores;Postoperative VAS leg,VAS back and ODI Scores and duration of surgery(p<0.05).Time duration for surgery was also seen more in the elder patients(>55years age group).There was no statistically significant difference in days of hospital(p>0.05).Macnab's criteria for all the variables were mostly in Excellent and good groups.Conclusion: Percutaneous Transforaminal endoscopic lumbar spine surgery is a good and effective technique in spine surgery to relieve symptoms for low back pain with satisfactory outcome,short hospital stays and the advantage of no need of general anesthesia for elder patient.This technique shows good postoperative effects in all age group,in both gender and in both Lumbar Disc Hernaition and Lumbar Stenosis Patients.