ArticleJournal of spine surgery (Hong Kong)2020
Risk factors predicting less favorable outcomes in endoscopic lumbar discectomies.
Article in Journal of spine surgery (Hong Kong), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 11 citations in OpenAlex.
- Intraoperative neuromonitoring use in posterior endoscopic cervical decompression: can it reduce complications?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- A Systematic Review and Meta-Analysis of Preoperative Characteristics and Postoperative Outcomes in Patients Undergoing Endoscopic Spine Surgery: Part I Endoscopic Microdiscectomy.Journal of clinical medicine · 2025Review
- Knowledge, attitudes, and practices regarding lumbar disc herniation among diagnosed patients.Frontiers in public health · 2025Article
- Therapeutic efficacy of endoscopic lumbar interbody fusion in patients with lumbar instability and analysis of prognostic factors.American journal of translational research · 2025Article
- A Proposed Personalized Spine Care Protocol (SpineScreen) to Treat Visualized Pain Generators: An Illustrative Study Comparing Clinical Outcomes and Postoperative Reoperations between Targeted Endoscopic Lumbar Decompression Surgery, Minimally Invasive TLIF and Open Laminectomy.Journal of personalized medicine · 2022Article
- A Differential Clinical Benefit Examination of Full Lumbar Endoscopy vs Interspinous Process Spacers in the Treatment of Spinal Stenosis: An Effect Size Meta-Analysis of Clinical Outcomes.International journal of spine surgery · 2022Article
- Value of Lumbar MRI Parameters in the Evaluation of Postoperative Curative Effect on Patients with Lumbar Disc Herniation and Analysis of Risk Factors.Evidence-based complementary and alternative medicine : eCAM · 2021Article
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndoscopic lumbar discectomy was among the first minimally invasive spine procedures commonly performed. As such, all the benefits of minimal invasion were seen, including less pain, less soft tissue destruction, and faster recovery. While outcomes compare favorably to micro and open discectomy, not all patients fare equally well. This paper examines independent risk factors to assess their correlation to suboptimal outcomes after endoscopic lumbar discectomy.
methodsRetrospective analysis of clinical outcomes of 55 consecutive patients treated with endoscopic discectomy between June 2018 and March 2019 by the author. Primary outcome measures were postoperative reductions of visual analog score (VAS) for back and leg pain modified MacNab criteria as well as time to narcotic independence. Risk factors examined included smoking, facet disease, adjacent segments disc degeneration, obesity, alcohol abuse, and psychiatric illness.
resultsThere were 31 males and 24 females with a mean age of 41.76±12.53. Most patients suffered from contained herniations (49.1%) followed by extruded herniations (18.2%). Follow-up ranged from 6-18 months. The most common surgical levels were L5-S1 level (30.9%), L4-S1 (29.1%), and L4-5 (25.5%). The mean return to work (RTW) was 23.83±26.01 weeks. The average body mass index (BMI) was 29.11±4.75. The average time for narcotic independence was 9.64±7.29 days. MacNab outcomes showed that 47.3% (26/55) had excellent, 36.4% good (20/55), 12.7% fair (7/55), and 3.6% had poor (2/55), respectively. The VAS scores for the back (7.69 to 2.65) and leg (6.78 to 2.65) pain reduced significantly (P<0.0001). Smoking (P=0.048), psychiatric disease (P=0.029), disc herniations larger than 10 mm, facet disease, obesity (BMI >30), diabetes, and alcohol abuse was associated with fair and poor MacNab outcomes.
conclusionsEndoscopic lumbar discectomy safely and reliably reduces axial pain and radiculopathy from lumbar disc herniations. Risk factors associated with incomplete pain relief are large herniations, obesity, instability, smoking, advanced facet degeneration, and decreased ability to cope with the surgery.
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