Transforaminal Percutaneous Endoscopic Discectomy for Lumbar Disc Herniation in Parkinson's Disease: A Case-Control Study

Study Design: A case-control study. Purpose: To investigate the effectiveness of transforaminal percutaneous endoscopic discectomy (TPED) in Parkinson's disease (PD). Overview of Literature: Patients with PD frequently suffer from radiculopathy and low back pain. Additionally, they demonstrate higher complication rates after open spine surgery. However, the clinical outcome of minimally invasive techniques for lumbar discectomy, such as TPED, have not been established for this population. Methods: Patients diagnosed with lumbar disc hernia were divided into Group A (11 patients diagnosed with PD), and Group B (10 patients as the control, non-PD group). All patients underwent TPED. Indexes of visual analogue scale (VAS) for leg pain and Oswestry disability index (ODI) were assessed right before surgery and at six weeks, three months, six months and one year post-surgery. Results: At the baseline visit, groups did not differ significantly with age (p=0.724), gender (p=0.835), level of operation (p=0.407), ODI (p=0.497) and VAS (p=0.772). Parkinson's patients had higher scores in ODI at every visit, but the outcome was statistically significant only at 3 months (p=0.004) and one year (p=0.007). Similarly, VAS measurements were higher at each time point, with the difference being significant at 3 (p<0.001), 6 (0.021), and 12 (p<0.001) months after surgery. At the end of a year of follow up, ODI was reduced by 49.6% (+/- 16.7) in Group A and 59.2% (+/- 8.0) in Group B (p=0.111), translating to a 79.5% (+/- 13.0) and 91.5% (+/- 4.1) average improvement in daily functionality (p=0.024). VAS was reduced by 59.1 mm (+/- 11.8) in Group A and 62.2 mm (+/- 7.4) in Group B (p=0.485), leading to an 85.3 % (+/- 4.0) and 91.9% (+/- 2.6) general improvement in leg pain (p<0.001). Conclusions: Our data indicate that TPED led to satisfactory improvement in leg pain and daily living in PD patients a year after surgery.