{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T16:50:46Z","timestamp":1774889446489,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive surgical technique for the treatment of lumbar disc herniation. Despite its growing popularity, limited research has explored the influence of patient characteristics and the choice of technique on post-operative outcomes and patient satisfaction. Objective: To investigate the impact of patient characteristics and surgical technique (interlaminar vs. transforaminal) on the surgical outcomes and patient satisfaction following PELD. Methods: A retrospective analysis was conducted on 177 patients who underwent PELD (53.1% males, age = 46.11 \u00b1 14.2 years), including 147 patients with the interlaminar approach and 30 with the transforaminal approach. Demographic data, pre-operative clinical features, surgical technique, intra-operative and post-operative complications and complaints, patient-reported outcomes (disability, quality of life, satisfaction), and revision surgery rates were documented and analyzed. The mean follow-up duration was 5.55 years \u00b1 2.73 years. Results: No significant differences were observed in demographics, pre-operative status, or post-operative complaints and complication rates between two surgical techniques, except that transforaminal technique showed a higher incidence for dural tear and persistent muscle weakness (p = 0.028 and p = 0.046, respectively). Both techniques led to excellent patient-reported outcomes with no significant differences. Total patient satisfaction with PELD was 93.8%, which correlated positively with the absence of complications and complaints and negatively with persistent back pain, recurrent herniation and revision surgery. Conclusions: Interlaminar and transforaminal PELD are both effective and safe minimally invasive surgical techniques for the treatment of lumbar disc herniation with a high patient satisfaction rate. Further prospective studies are warranted to confirm these findings.<\/jats:p>","DOI":"10.3390\/jcm14051411","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T04:53:39Z","timestamp":1740027219000},"page":"1411","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of Patient\u2019s Characteristics and Surgical Technique on the Patient Outcomes and Satisfaction After Endoscopic Lumbar Discectomy\u2014A Long-Term Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9494-3234","authenticated-orcid":false,"given":"Youssef","family":"Jamaleddine","sequence":"first","affiliation":[{"name":"Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut 0379, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9006-164X","authenticated-orcid":false,"given":"Ahmad","family":"Haj Hussein","sequence":"additional","affiliation":[{"name":"Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut 0379, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Afyouni","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lebanese University, Hadath 1533, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaid","family":"Mayta","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Beirut Arab University, Beirut 1107, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8089-1883","authenticated-orcid":false,"given":"Lemir Majed","family":"El Ayoubi","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lebanese University, Hadath 1533, Lebanon"},{"name":"Department of Neurology, American University of Beirut Medical Center, Beirut 1107, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4780-0772","authenticated-orcid":false,"given":"Pascale","family":"Salameh","sequence":"additional","affiliation":[{"name":"Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut 0379, Lebanon"},{"name":"Faculty of Pharmacy, Lebanese University, Hadath 1533, Lebanon"},{"name":"Institut National de Sant\u00e9 Publique d\u2019\u00c9pid\u00e9miologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramzi","family":"Moucharafieh","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Balamand University, Beirut 1300, Lebanon"},{"name":"Department of Orthopedics and Traumatology, Clemenceau Medical Center, Beirut P.O. Box 11-2555, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1622-2384","authenticated-orcid":false,"given":"Mohamad Omar","family":"Honeine","sequence":"additional","affiliation":[{"name":"Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut 0379, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Badra","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Balamand University, Beirut 1300, Lebanon"},{"name":"Department of Orthopedics and Traumatology, Clemenceau Medical Center, Beirut P.O. Box 11-2555, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"ref_1","unstructured":"Al Qaraghli, M.I., and De Jesus, O. (2024). Lumbar Disc Herniation. StatPearls, StatPearls Publishing."},{"key":"ref_2","unstructured":"Dydyk, A.M., Ngnitewe Massa, R., and Mesfin, F.B. (2024). Disc Herniation. StatPearls, StatPearls Publishing."},{"key":"ref_3","unstructured":"Donnally III, C.J., Hanna, A., and Varacallo, M. (2023). Lumbar Degenerative Disk Disease. StatPearls, StatPearls Publishing."},{"key":"ref_4","unstructured":"Samartzis, D., Karppinen, J.I., Williams, F.M.K., Samartzis, D., Karppinen, J.I., and Williams, F.M.K. (2022). 8\u2014Displacement of Intervertebral Discs. Spine Phenotypes, Elsevier."},{"key":"ref_5","unstructured":"Slipped Disc (2025, February 09). nhs.uk 2017. Available online: https:\/\/www.nhs.uk\/conditions\/slipped-disc\/."},{"key":"ref_6","unstructured":"(2023, July 24). Herniated Disc\u2014Symptoms, Causes, Prevention and Treatments. Available online: https:\/\/www.aans.org\/Patients\/Neurosurgical-Conditions-and-Treatments\/Herniated-Disc."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"(2025, February 09). Surgical Versus Conservative Treatment for Lumbar Disc Herniation: A Prospective Cohort Study | BMJ Open. Available online: https:\/\/bmjopen.bmj.com\/content\/6\/12\/e012938?utm_source=chatgpt.com.","DOI":"10.1136\/bmjopen-2016-012938"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"E488","DOI":"10.1097\/BRS.0b013e3181cc3f56","article-title":"Conservative Management of Lumbar Disc Herniation with Associated Radiculopathy: A Systematic Review","volume":"35","author":"Hahne","year":"2010","journal-title":"Spine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1097\/00007632-199508150-00015","article-title":"Open Discectomy as Treatment for Herniated Nucleus Pulposus of the Lumbar Spine","volume":"20","author":"Errico","year":"1995","journal-title":"Spine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.wneu.2018.02.156","article-title":"Operative Approaches for Lumbar Disc Herniation: A Systematic Review and Multiple Treatment Meta-Analysis of Conventional and Minimally Invasive Surgeries","volume":"114","author":"Alvi","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.wneu.2020.08.008","article-title":"A Historical Review of Endoscopic Spinal Discectomy","volume":"145","author":"Ahn","year":"2021","journal-title":"World Neurosurg"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1007\/s00264-018-04283-w","article-title":"Endoscopic Spine Discectomy: Indications and Outcomes","volume":"43","author":"Ahn","year":"2019","journal-title":"Int. Orthop."},{"key":"ref_13","first-page":"49","article-title":"Percutaneous Endoscopic Lumbar Discectomy: Indications and Complications","volume":"23","author":"Pan","year":"2020","journal-title":"Pain Physician"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"B30","DOI":"10.1097\/BRS.0000000000001810","article-title":"Percutaneous Endoscopic Lumbar Discectomy for L5-S1 Disc Herniation Via an Interlaminar Approach Versus a Transforaminal Approach: A Prospective Randomized Controlled Study With 2-Year Follow Up","volume":"41","author":"Nie","year":"2016","journal-title":"Spine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-Item Short-Form Health Survey (SF-36). I. Conceptual Framework and Item Selection","volume":"30","author":"Ware","year":"1992","journal-title":"Med. Care"},{"key":"ref_16","unstructured":"(2025, February 09). 12-Item Short Form Survey (SF-12)\u2014Physiopedia. Available online: https:\/\/www.physio-pedia.com\/12-Item_Short_Form_Survey_(SF-12)."},{"key":"ref_17","unstructured":"Technology, C. (2024, April 05). Oswestry Disability Index (ODI). Available online: https:\/\/www.codetechnology.com\/blog\/oswestry-disability-index\/."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1111\/os.14031","article-title":"Modified Percutaneous Endoscopic Interlaminar Discectomy through the Near-Spinous Process Approach for L4\/5 Disc Herniation: A Retrospective Clinical Study","volume":"16","author":"Xu","year":"2024","journal-title":"Orthop. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1177\/21925682221120530","article-title":"Transforaminal Versus Interlaminar Endoscopic Lumbar Discectomy for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis","volume":"13","author":"Jitpakdee","year":"2023","journal-title":"Glob. Spine J."},{"key":"ref_20","unstructured":"SciELO (2025, February 09). Brazil\u2014Comparison of Two Endoscopic Spine Surgical Techniques Comparison of Two Endoscopic Spine Surgical Techniques. Available online: https:\/\/www.scielo.br\/j\/ramb\/a\/ZfQLcN7qr9mW8JMhSNCfq9P\/?utm_source=chatgpt.com."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s13018-024-04543-z","article-title":"Percutaneous Endoscopic Transforaminal vs. Interlaminar Discectomy for L5\u2013S1 Lumbar Disc Herniation: A Retrospective Propensity Score Matching Study","volume":"19","author":"Li","year":"2024","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Cheng, Y.-P., Cheng, X.-K., and Wu, H. (2022). A Comparative Study of Percutaneous Endoscopic Interlaminar Discectomy and Transforaminal Discectomy for L5-S1 Calcified Lumbar Disc Herniation. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-022-05186-z"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e413","DOI":"10.1016\/j.wneu.2020.10.105","article-title":"Early Clinical Outcomes of Percutaneous Endoscopic Lumbar Discectomy for L4-5 Highly Down-Migrated Disc Herniation: Interlaminar Approach Versus Transforaminal Approach","volume":"146","author":"Huang","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/s00586-015-3776-6","article-title":"A Meta-Analysis of Endoscopic Discectomy versus Open Discectomy for Symptomatic Lumbar Disk Herniation","volume":"25","author":"Cong","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1227\/00006123-199108000-00027","article-title":"Lumbar Disc Surgery: Results of the Prospective Lumbar Discectomy Study of the Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons","volume":"29","author":"Abramovitz","year":"1991","journal-title":"Neurosurgery"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"276","DOI":"10.6061\/clinics\/2016(05)06","article-title":"Randomized Clinical Trial Comparing Lumbar Percutaneous Hydrodiscectomy with Lumbar Open Microdiscectomy for the Treatment of Lumbar Disc Protrusions and Herniations","volume":"71","author":"Cristante","year":"2016","journal-title":"Clinics"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1111\/os.12909","article-title":"Comparison of Percutaneous Transforaminal Endoscopic Discectomy and Microscope-Assisted Tubular Discectomy for Lumbar Disc Herniation","volume":"13","author":"Liu","year":"2021","journal-title":"Orthop. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e065846","DOI":"10.1136\/bmj-2021-065846","article-title":"Full Endoscopic versus Open Discectomy for Sciatica: Randomised Controlled Non-Inferiority Trial","volume":"376","author":"Gadjradj","year":"2022","journal-title":"BMJ"},{"key":"ref_29","first-page":"CD010328","article-title":"Minimally Invasive Discectomy versus Microdiscectomy\/Open Discectomy for Symptomatic Lumbar Disc Herniation","volume":"2014","author":"Rasouli","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_30","first-page":"e622","article-title":"Treatment of Recurrent Disc Herniation: A Systematic Review","volume":"8","author":"Drazin","year":"2016","journal-title":"Cureus"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"077","DOI":"10.1055\/s-0034-1386750","article-title":"Microdiscectomy for the Treatment of Lumbar Disc Herniation: An Evaluation of Reoperations and Long-Term Outcomes","volume":"05","author":"Aichmair","year":"2014","journal-title":"Evid.-Based Spine-Care J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"E8","DOI":"10.1097\/BSD.0b013e31828da8f1","article-title":"Limited Microdiscectomy for Lumbar Disk Herniation: A Retrospective Long-Term Outcome Analysis","volume":"27","author":"Soliman","year":"2014","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1302\/0301-620X.103B8.BJJ-2020-2541.R2","article-title":"Risk of Reoperation and Infection after Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Discectomy: A Nationwide Population-Based Study","volume":"103-B","author":"Kang","year":"2021","journal-title":"Bone Jt. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"100754","DOI":"10.1016\/j.semss.2019.100754","article-title":"Postoperative Spine Infections","volume":"31","author":"Attenello","year":"2019","journal-title":"Semin. Spine Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.wneu.2018.08.236","article-title":"Percutaneous Endoscopic Lumbar Discectomy Versus Posterior Open Lumbar Microdiscectomy for the Treatment of Symptomatic Lumbar Disc Herniation: A Systemic Review and Meta-Analysis","volume":"120","author":"Qin","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s00586-010-1493-8","article-title":"Dural Tears in Percutaneous Endoscopic Lumbar Discectomy","volume":"20","author":"Ahn","year":"2011","journal-title":"Eur. Spine J."},{"key":"ref_37","first-page":"e14360","article-title":"Clinical Outcomes of Incidental Dural Tears During Lumbar Microdiscectomy","volume":"13","author":"Akpinar","year":"2021","journal-title":"Cureus"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"178","DOI":"10.5152\/eurasianjmed.2018.18016","article-title":"Open Discectomy vs. Microdiscectomy: Results from 519 Patients Operated for Lumbar Disc Herniation","volume":"50","author":"Calikoglu","year":"2018","journal-title":"Eurasian J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"779","DOI":"10.2147\/IJGM.S293400","article-title":"Minimum Seven-Year Follow-Up Outcomes of Percutaneous Endoscopic Lumbar Discectomy for Lumbar Degenerative Disease","volume":"14","author":"Li","year":"2021","journal-title":"Int. J. Gen. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/5\/1411\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:38:37Z","timestamp":1760027917000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/5\/1411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,20]]},"references-count":39,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["jcm14051411"],"URL":"https:\/\/doi.org\/10.3390\/jcm14051411","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,20]]}}}