Clinical Efficacy of Percutaneous Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation in Patients Over 70 Years Old

Clin Spine Surg. 2025 Jun 20. doi: 10.1097/BSD.0000000000001862. Online ahead of print.

Abstract

Study design: A retrospective study.

Objective: To study the efficacy of percutaneous endoscopic discectomy (PED) for treating LDH patients over 70 years old.

Summary of background data: PED is considered an effective surgical method for treating LDH, but few studies have focused on the clinical efficacy of PED in elderly patients with LDH.

Materials and methods: LDH patients over 70 years old with radicular pain or signs of radiculopathy were included. All patients underwent PED under local/general anesthesia. Operative time, length of hospital stay, complications, visual analogue score (VAS) and the Oswestry Disability Index (ODI) were assessed preoperatively, 3 days postoperatively, 3 months postoperatively, 6 months postoperatively, and 12 months postoperatively. A paired-sample t test was performed to compare differences in the ODI and VAS scores between the preoperative, postoperative and follow-up periods.

Results: A total of 132 patients over 70 years old with LDH were included. The average age was 75.31 years. No related complications occurred, and there was no recurrence of LDH within 12 months after surgery. The differences in the VAS scores and the ODI scores before and after surgery were statistically significant (P<0.0001). Differences in the ODI scores at 3 months, 6 months, and 12 months after surgery were statistically significant (P<0.0001). There were significant differences in the VAS scores at 3 days, 3 months, and 6 months after surgery (P<0.0001). However, the differences in VAS scores between 6 months after surgery and 12 months after surgery were not statistically significant (P=0.083).

Conclusions: Our results demonstrated that PED is a safe and effective technique for elderly patients with LDH and that it yields significant improvements in pain and functional outcomes.

Keywords: efficacy; lumbar disc herniation; patients over 70 years old; percutaneous endoscopic discectomy technique.