Percutaneous Transforaminal Endoscopic Lumbar Discectomy in Obese Patients

Abstract Background: Obese patients are at higher risk of compli-cations after spinal surgery such as slower wound healing and increased infection rates. Percutaneous Endoscopic Lumbar Discectomy (PELD) has advantages over conventional micro-discectomy because it decreases perioperative complications and increases favorable clinical outcomes. Aim of Study: The aim of this study is to evaluate the clinical outcomes of PELD in obese patients as compared to patients who have a normal body mass index. Patients and Methods: Obesity is defined as a Body Mass Index (BMI) of more than 30kg/m2. Our study included 32 obese patients and 35 normal BMI patients treated by PELD for radiating pain caused by a single-level lumbar disc herni-ation. Clinical and functional outcomes using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) and follow-up was done at 2 weeks, 1, 2, 6 and 12 months post-operatively. All surgeries were done by the same surgeon. Results: Overall clinical and functional outcomes were improved during post-operative follow-up evaluation. There were no immediate perioperative complications, such as infection or durotomy in both groups. In the obese group, two patients had late re-herniation, of these, 1 patients had tolerable pain and showed good recovery with conservative treatment; 1 patient underwent another PELD surgery. In control group, there was one early reherniations which occurred within a months after PELD, which patient underwent conventional microdiscectomy. Conclusion: PELD is an effective, safe, and minimally invasive technique for obese patients. The PELD decreases the post-operative morbidity and allows for faster mobility and rehabilitation. The results were comparable to patients with normal body mass index.