ArticleOrthopaedic surgery2024
Surgical Strategy for Lumbar Disc Herniation based on the MSU Classification: Percutaneous Endoscopic Lumbar Discectomy versus Transforaminal Lumbar Interbody Fusion: A 5-year Retrospective Study.
Article in Orthopaedic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Decompression with interbody fusion versus decompression alone for degenerative lumbar diseases: A meta-analysis.PloS one · 2025Pooled it
- Comparison of Machine Learning Models for Predicting Recurrent Lumbar Disc Herniation After Percutaneous Endoscopic Lumbar Discectomy.Journal of clinical medicine · 2026Article
- Radiological characteristics in coronal and sagittal planes and short-term postoperative outcomes in patients with lumbar disc herniation accompanied by sciatic scoliosis.Scientific reports · 2026Article
- Clinical Application of Deep Learning for Spine MRI Interpretation: A Multicenter Evaluation of Artificial-Intelligence-Assisted versus Manual Reading on Diagnostic Agreement with the Reference Standard.Research (Washington, D.C.) · 2026Article
- The first week matters: App-based PROM trajectories and follow-up retention after endoscopic lumbar surgery.Brain & spine · 2026Article
- Whole process navigated percutaneous endoscopic lumbar discectomy guided by a novel X-ray instant navigation: a technical report and preliminary clinical outcomes.BMC musculoskeletal disorders · 2025Article
- Efficacy of Selective Nerve Root Block for Different Types of Lumbar Disc Herniation: Study Protocol for a Single-Blind, Prospective Cohort Study.Journal of pain research · 2025Article
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Abstract
objectiveCurrently, there is no established guideline on whether to opt for percutaneous endoscopic lumbar discectomy (PELD) or traditional transforaminal lumbar interbody fusion (TLIF) surgery based on specific types of lumbar disc herniation (LDH). Based on the Michigan State University (MSU) classification system, this study conducted a medium- to long-term follow-up analysis of two surgical methods over 5 years for the first time, aiming to provide empirical evidence to assist in making more informed decisions before surgery for LDH treatment.
methodsThis was a retrospective study that included 273 patients with single-level LDH who underwent PELD or TLIF treatment at our hospital between January 1, 2016, and December 31, 2018. Detailed metrics included preoperative and postoperative visual analogue scale (VAS) scores and Oswestry disability index (ODI) at 1-day, 1-week, 1-year, and 5-year follow-ups. Complications, recurrences, and 5-year postoperative modified MacNab criteria scores were also recorded. Statistical methods included independent sample t-tests, repeated measures analysis of variance (ANOVA), and χ
resultsClassified into seven groups according to the MSU classification, it was found that there was an improvement in the VAS and ODI scores at four postoperative follow-ups (p < 0.001). PELD showed better results than TLIF in reducing pain and improving the ODI scores in the classifications of 3B, 2B, and 2C (p < 0.05). TLIF demonstrated consistent superiority over PELD in 2A, 2AB, 3A, and 3AB classifications (p < 0.05). The total recurrence rate in the PELD group (11.05%) within 5 years after surgery was higher (p < 0.05) than that in the TLIF group (3.96%). These were mainly concentrated in the 2A, 2AB, 3A, and 3AB types. Moreover, the rate of excellent and good outcomes in the PELD was higher than in the TLIF but no significant difference (χ
conclusionThis study suggests that PELD and TLIF may relieve LDH, but have advantages under different MSU classifications. The MSU classification has specific guiding significance and could aid in the surgical selection of PELD or TLIF to achieve optimal treatment outcomes for patients with lumbar disc herniation.
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