Transforaminal Percutaneous Endoscopic Discectomy in Parkinson Disease: Preliminary Results and Short Review of the Literature

Abstract

Objective: To study the effectiveness of Transforaminal Percutaneous Endoscopic Discectomy (TPED) for lumbar disc herniation in patients with Parkinson disease (PD).

Methods: Fifteen patients diagnosed with PD and lumbar disc hernia were recruited to the study. All patients underwent TPED. Mean age was 61.27±6 years, with 8 male (53.3%) and 7 female patients (46.7%). Level of operation was L3-4 (33.3%), L4-5 (33.3%) and L5-S1 (33.3%). Visual analogue scale (VAS) for leg pain and Oswestry Disabillity Index (ODI) for back pain, as well as the Medical Outcomes Study Questionnaire Short-Form 36 Health Survey (SF-36) for health-related quality of life (HRQoL) were assessed right before surgery and at 6 weeks, 3, 6, and 12 months after surgery.

Results: VAS and ODI showed significant (p<0.005) reduction one year after TPED, with a percentage improvement of 83.9% and 79.4%, respectively. Similarly, all aspects of quality of life (SF-36) were significantly (p<0.005) improved 1 year after the procedure. Bodily pain and role physical demonstrated the highest increase followed by role emotional, physical function, social function, vitality, mental health, and general health. Beneficial impact of TPED on clinical outcome and HRQoL was independent of gender and operated level.

Conclusion: TPED is effective in reducing lower limb symptoms and low back pain in patients with lumbar disc hernia, suffering from PD. Positive effect of endoscopy is, also, evident in HRQoL of those patients one year after the procedure.

Keywords: Endoscopy; Parkinson disease; Percutaneous discectomy; Quality of life.

Fig. 1. Progressive change of ODI, VAS, and SF-36 during the follow-up period. Comparative progress of VAS, ODI, and SF-36 components is highlighted with different colors, from baseline to 12 months postoperatively. VAS, visual analogue scale; ODI, Oswestry Disabillity Index; SF-36, Medical Outcomes Study Short-form Questionnaire; PF, physical function; RP, role physical; BP, bodily pain; GH, general health; V, vitality; SF, social function; RE, role limitations due to emotional problems; MH, mental health.