Health-related quality of life after transforaminal percutaneous endoscopic discectomy: An analysis according to the level of operation

Background: Many patients suffer from radiculopathy and low back pain due to lumbar disc hernia. Transforaminal percutaneous endoscopic discectomy (TPED) is a minimally invasive method that accesses the disc pathology through the intervertebral foramen. Health-related quality of life (HRQoL) has been previously assessed for this method. However, a possible effect of the level of operation on the postoperative progress of HRQoL remains undefined.Purpose: The purpose of this study was to evaluate the impact of the level of operation on HRQoL, following TPED.Patients and Methods: A total of 76 patients diagnosed with lumbar disc hernia were enrolled in the study. According to the level of operation, they were divided into three groups: Group A (21 patients) for L3–L4, Group B (40 patients) for L4–L5, and Group C (15 patients) for L5–S1 intervertebral level. All patients underwent TPED. Their HRQoL was evaluated by the short-form-36 (SF-36) health survey questionnaire before the operation and at 6 weeks, 3, 6, and 12 months postsurgery. The progress of SF-36 was analyzed in relation to the operated level.Results: All aspects of SF-36 showed statistical significant improvement, at every given time interval (P ≤ 0.05) in the total of patients and in each group separately. Group A had a significantly higher increase in physical functioning (PF) score at 3 and 12 months postsurgery (P = 0.046 and P = 0.056, respectively). On the other hand, Group B had a significant lower increase in mental health (MH) score at 6 months (P = 0.009) postoperatively.Conclusion: Our study concludes that the level of operation in patients who undergo TPED for lumbar disc herniation affects the HRQoL 1 year after surgery, with Group A having a significantly greater improvement of PF in comparison with Groups B and C.