Comparison of MED and PELD in the Treatment of Adolescent Lumbar Disc Herniation: A 5-Year Retrospective Follow-Up.

OBJECTIVE: To compare the efficacy and safety of minimally endoscopic discectomy (MED) and percutaneous endoscopic lumbar discectomy (PELD) in the treatment of adolescent lumbar disc herniation (ALDH). METHODS: We retrospectively collected data from 30 patients with ALDH who underwent MED and 48 patients with ALDH who underwent PELD at our hospital between January 2010 and January 2012. Baseline data included age, sex, symptom duration, and surgical segment. Perioperative data included duration of surgery duration, blood loss, and duration of postoperative hospitalization. The Oswestry Disability Index (ODI) and visual analog scale (VAS) for both the lower back and leg were recorded as surgical outcomes. All surgical outcomes were recorded before surgery, at 1 week after surgery, at 6 months after surgery, and at final follow-up. RESULTS: There were no significant differences in baseline data between the MED and PELD groups. Both groups showed improvements in ODI and VAS scores before surgery and at the final follow-up time point (P < 0.05); however, the MED group had a higher mean ODI score at 1 week (12.44 ± 6.39 vs. 7.25 ± 6.40; P = 0.02) and 6 months (9.33 ± 7.43 vs. 3.97 ± 7.64; P = 0.04) after surgery. In addition, mean VAS scores for lower back pain were higher in the MED group at 1 week (1.93 ± 1.39 vs. 0.91 ± 0.85; P = 0.01), 6 months (1.80 ± 1.15 vs. 0.61 ± 0.94; P = 0.00), and final follow-up (1.87 ± 1.46 vs. 0.65 ± 0.88; P = 0.00), as was mean VAS score for radicular pain at 1 week after surgery (1.48 ± 0.76 vs. 0.74 ± 0.81; P = 0.01). One patient in each group experienced recurrent lumbar disc herniation. No other complications were reported in either group. CONCLUSIONS: Both PELD and MED are effective and safe surgical techniques for the treatment of ALDH; however, compared with MED, PELD is more advantageous for lower back pain and provides more rapid resolution of radicular pain.