How reliable is percutaneous transforaminal endoscopic discectomy during the learning curve? A comparison of outcomes with microsurgical discectomy experiences
5 affiliations
- 1Department of Neurosurgery, Etlik City Hospital, Ankara, 06110 Turkey
- 2Department of Neurosurgery, İzmir Economy University Medical Point Hospital, İzmir, Turkey
- 3Department of Neurosurgery, Acıbadem Maslak Hospital, İstanbul, Turkey
- 4Department of Neurosurgery İzmir, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
- 5Freelance Physician, Izmir, Turkey
Abstract
Objective: We aimed to share our early experience with percutaneous transforaminal endoscopic discectomy (PTED) during the initial phase of the learning curve and to compare its clinical and perioperative outcomes with microsurgical discectomy (MD) in selected patients with symptomatic lumbar disc herniation (LDH).
Methods: In this retrospective study, patients who underwent PTED or MD for symptomatic LDH since 2019 and completed at least 6 months of postoperative follow-up were analyzed. Patients with acute paresis, cauda equina syndrome, significant concomitant spinal stenosis, calcified disc herniation, high-positioned iliac crest preventing safe transforaminal access, markedly migrated disc fragments, or a need for multilevel surgery were excluded from the comparative cohort. VAS and ODI scores, operative duration, transfusion requirement, length of stay, complications, follow-up, and reoperation rates were evaluated.
Results: A total of 185 patients (88 PTED and 97 MD) were included. Postoperative VAS scores and ODI changes were not significantly different between the groups, while both techniques produced significant postoperative pain improvement. Mean operative duration was similar between the groups. PTED was associated with a shorter hospital stay (p < 0.001) and fewer perioperative complications (p = 0.004). No patient in the PTED group required transfusion; however, this variable should be interpreted as transfusion requirement rather than measured blood loss. Reoperation was required in 11 patients (7 PTED and 4 MD), without a statistically significant difference between groups (p = 0.125).
Conclusion: In carefully selected patients with symptomatic lumbar disc herniation, PTED provided postoperative pain relief and functional outcomes comparable to MD, even during the early learning curve period. PTED was also associated with shorter hospital stay and fewer postoperative complications, while operative times were similar between groups. However, given the retrospective design and selected patient population, these findings should be confirmed by prospective studies with longer follow-up and quantitative learning curve analysis.
Related
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- Unilateral Biportal Endoscopy Versus Percutaneous Endoscopic Interlaminar Discectomy for Highly Migrated Lumbar Disc Herniation: A Retrospective Comparative Study With Quantitative MRI-Based Decompression Analysis.
BibTeX
@article{uzunoglu2026reliable,
title = {{How reliable is percutaneous transforaminal endoscopic discectomy during the learning curve? A comparison of outcomes with microsurgical discectomy experiences}},
author = {İnan Uzunoğlu and Gökhan Gürkan and Ege Coşkun and Atakan Besnek and Ceren Kızmazoğlu and Orhan Kalemci and Murat Sayın},
journal = {BMC Surgery},
year = {2026},
month = aug,
doi = {10.1186/s12893-026-04088-4},
url = {https://doi.org/10.1186/s12893-026-04088-4},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - How reliable is percutaneous transforaminal endoscopic discectomy during the learning curve? A comparison of outcomes with microsurgical discectomy experiences
AU - İnan Uzunoğlu
AU - Gökhan Gürkan
AU - Ege Coşkun
AU - Atakan Besnek
AU - Ceren Kızmazoğlu
AU - Orhan Kalemci
AU - Murat Sayın
PY - 2026
DA - 2026/08/10
JO - BMC Surgery
DO - 10.1186/s12893-026-04088-4
UR - https://doi.org/10.1186/s12893-026-04088-4
AB - Objective: We aimed to share our early experience with percutaneous transforaminal endoscopic discectomy (PTED) during the initial phase of the learning curve and to compare its clinical and perioperative outcomes with microsurgical discectomy (MD) in selected patients with symptomatic lumbar disc herniation (LDH). Methods: In this retrospective study, patients who underwent PTED or MD for symptomatic LDH since 2019 and completed at least 6 months of postoperative follow-up were analyzed. Patients with acute paresis, cauda equina syndrome, significant concomitant spinal stenosis, calcified disc herniation, high-positioned iliac crest preventing safe transforaminal access, markedly migrated disc fragments, or a need for multilevel surgery were excluded from the comparative cohort. VAS and ODI scores, operative duration, transfusion requirement, length of stay, complications, follow-up, and reoperation rates were evaluated. Results: A total of 185 patients (88 PTED and 97 MD) were included. Postoperative VAS scores and ODI changes were not significantly different between the groups, while both techniques produced significant postoperative pain improvement. Mean operative duration was similar between the groups. PTED was associated with a shorter hospital stay (p < 0.001) and fewer perioperative complications (p = 0.004). No patient in the PTED group required transfusion; however, this variable should be interpreted as transfusion requirement rather than measured blood loss. Reoperation was required in 11 patients (7 PTED and 4 MD), without a statistically significant difference between groups (p = 0.125). Conclusion: In carefully selected patients with symptomatic lumbar disc herniation, PTED provided postoperative pain relief and functional outcomes comparable to MD, even during the early learning curve period. PTED was also associated with shorter hospital stay and fewer postoperative complications, while operative times were similar between groups. However, given the retrospective design and selected patient population, these findings should be confirmed by prospective studies with longer follow-up and quantitative learning curve analysis.
SN - 1471-2482
ER -