Application of Percutaneous Endoscopic Interlaminar Discectomy or Open Lumbar Microdiscectomy in Treating Senile Patients Over 60 Years Old with Symptomatic Lumbar Disc Herniation: A Two-year Retrospective Study

Abstract Background: Percutaneous endoscopic interlaminar discectomy (PEID) had been successfully used in the treatment of lumbar disc herniation. However, few reports have focused on the treatment of senile lumbar disc herniation (SLDH) in patients aged over 60 years via PEID. Methods: We included 42 patients with SLDH from January 2019 to June 2020 in this retrospective study. The patients were divided into the PEID group (n = 19) and the open lumbar microdiscectomy (OLM) group (n = 23) according to the type of surgical procedure they underwent. Basic clinical information, surgical information, and clinical effects were compared between the two groups.Results: The estimated blood loss, bed-rest time, and hospital stay in the PEID group were less than those in the OLM group (P < 0.05 each) but the surgery time in the PEID group was longer than that in the OLM group (P < 0.05). The visual analgesia scores for back pain (VAS-BP), visual analgesia scores radiating to the lower legs (VAS-LL), and Oswestry disability index (ODI) scores of the two groups were significantly decreased after surgery compared to the baseline scores (P < 0.05). The VAS-BP at the 1st week and 3rd month post-operation and the ODI at the 12th month and 24th month in the PEID group were lower than those in the OLM group (P < 0.05 each). Conclusion: Both PEID and OLM are safe and efficacious methods of treating SLDH. Compared with OLM, PEID has more advantages in reducing surgical trauma and decreasing postoperative low back pain in the early postoperative period. The long-term clinical results of both techniques seem to be effective without any of them being superior to the other in elderly patients.