Percutaneous Transforaminal Endoscopic Discectomy vs. Open Microdiscectomy for Lumbar Disc Herniation (PTED-study)

Launched by AMSTERDAM UMC, LOCATION VUMC · Nov 9, 2015

Keywords

ClinConnect Summary

Rationale: Lumbosacral radicular syndrome (LSRS) is caused by a herniated lumbar nucleus pulposus (HNP) and the estimated annual incidence in The Netherlands ranges between 60,000 to 75,000 people. Open microdiscectomy is the standard surgical technique.

In recent years, several surgical techniques have been developed including, percutaneous transforaminal endoscopic discectomy (PTED). While PTED is gaining popularity in The Netherlands, evidence of its effects is lacking, leading to a heated debate. The current position of Zorginstituut Nederland (ZiN) is that there is insufficient eviden...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 10 weeks of radiating pain with- or without motor or sensory loss in the leg, or with \> 6weeks of excessive radiating pain and no tendency for any clinical improvement and strong patient preference for surgery;
• • Indication for an operation according to consensus;
• • MRI demonstrating lumbar disc herniation with nerve compression with or without concomitant spinal or lateral recess stenosis or sequestration;
• • Sufficient knowledge of the Dutch language in order to complete forms and follow instructions independently.
• Exclusion Criteria:
• • Previous surgery on the same or adjacent disc level;
• • Cauda equina syndrome (CES);
• • Spondylytic or degenerative spondylolisthesis;
• • Pregnancy;
• • Severe comorbid medical or psychiatric disorder (ASA\>2);
• • Severe caudal or cranial sequestration;
• • Moving abroad at short notice