Complications such as hospital or emergency room readmission and infections are lower for patients undergoing outpatient transforaminal endoscopic decompression surgery for lumbar foraminal and lateral recess stenosis at an ASC, according to research published in the International Journal of Spine Surgery.
Researchers studied 1,839 transforaminal endoscopic decompression surgery patients at 2,076 levels who underwent surgery between 2006 and 2015 with an average follow up of 33 months. Only patients who underwent unilateral radiculopathy due to either herniated disc or lateral recess stenosis were included in the study. The researchers analyzed costs, readmissions and postoperative adverse events.
The key study details to know:
1. Patients reported excellent and good results in 82.2 percent of patients with extruded disc fragment. Contained disc herniations patients had excellent and good results 72.7 percent of the time. Patients with spinal stenosis had excellent to good results 75 percent of the time.
2. Four patients reported postoperative grade I complications, and another 13 patients reported grade II complications. Nine patients reported grade III complications, including three who had reherniation of the extruded disc within three months of the initial procedure.
3. There were 229 patients who developed postoperative dysesthetic leg pain associated with dorsal root ganglion irritation, which led to severe foraminal stenosis. Eighty patients reported "failure to cure."
4. Researchers concluded, "Complications after outpatient transforaminal endoscopic decompression surgery with respect to reherniation, wound infections, durotomy and nerve root injury are approximately one magnitude lower than equivalent reported complication rates with microdiscectomy while delivering comparable clinical outcomes and lower readmission rates to an emergency room or hospital. Significant cost savings are realized due to a considerably lower rate of decompensated postoperative medical problems."