Percutaneous transforaminal endoscopic discectomy effective for Sciatica - Video

Percutaneous transforaminal endoscopic discectomy (PTED) can be considered as an effective alternative to open microdiscectomy in treating sciatica, according to the latest research published in BMJ.

Sciatica is a common health problem in the general population, with a lifetime prevalence of up to 43%. Sciatica is characterized by radiating leg pain starting from the low back, at times accompanied by sensory or motor deficits, and most frequently caused by lumbar disc herniation. Sciatica has a favorable natural course in most people; however, surgery may be indicated if conservative treatment fails or progressive neurological deficits develop. The study conducted by Dutch researchers tried to assess whether percutaneous transforaminal endoscopic discectomy (PTED) is non-inferior to conventional open microdiscectomy in reduction of leg pain caused by lumbar disc herniation.

In the trial, 613 patients aged 18-70 years with at least six weeks of radiating leg pain caused by lumbar disc herniation. The trial included a predetermined set of 125 patients receiving PTED who were the learning curve cases performed by surgeons who did not do PTED before the trial.

The primary outcome was self-reported leg pain measured by a 0-100 visual analog scale at 12 months, assuming a non-inferiority margin of 5.0. Secondary outcomes included complications, reoperations, self-reported functional status as measured with the Oswestry Disability Index, the visual analog scale for back pain, health-related quality of life, and self-perceived recovery. Outcomes were measured until one year after surgery and were longitudinally analyzed according to the intention-to-treat principle. Patients belonging to the PTED learning curve were omitted from the primary analyses.