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Comparison of post-operative wound pain between interlaminar and transforaminal endoscopic spine surgery: which is superior?

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Study design

Prospective cohort study

Purpose

The objective is to compare post-operative wound pain in patients treated by endoscopic surgery between interlaminar and transforaminal approach at lumbar region.

Overview of literature

There are two common approaches for endoscopic lumbar spine surgery, interlaminar and transforaminal approach. The wound size of these two approaches is about the same. However, post-operative wound pain may differ according to the entrance area.

Methods

We conducted a prospectively cohort study including all patients underwent full endoscopic lumbar spine surgery by single surgeon between January 2016 to October 2019. Wound pain using visual analog scale (VAS) at post-operative day 1 and day 14 were collected. VAS back pain, VAS leg pain, Oswestry Disability Index (ODI), modified McNab criteria and complications were also collected.

Results

There were 313 patients included in the study. There was no significant difference in VAS wound pain between interlaminar and transforaminal group. Interestingly, subgroup analysis in interlaminar group found statistically significant higher VAS for wound pain at post-operative day 1 when significant bone resection was done by power burr. VAS back-leg pain and ODI have improved significantly between pre-operative and last follow up in both approaches.

Conclusions

Wound pain from endoscopic spine surgery is minimal. This study found no difference in wound pain between endoscopic interlaminar and transforaminal approach. Both approaches show favorable clinical outcomes with few serious complications rate. Further study with long term follow up is needed.

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Funding

The authors received no financial support for the research, authorship and/or publication of this article.

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Authors and Affiliations

  1. Spine Unit, Institute of Orthopedics, Lerdsin Hospital, Department of Orthopedic Surgery, College of Medicine, Rangsit University, 190 Silom Road, Bangkok, 10500, Thailand

    Pritsanai Pruttikul, Wichayan Chobchai, Tinnakorn Pluemvitayaporn, Sombat Kunakornsawat & Chaiwat Piyaskulkaew

  2. Upper Extremity and Reconstructive Microsurgery Unit, Institute of Orthopedics, Lerdsin Hospital, Department of Orthopedic Surgery, College of Medicine, Rangsit University, 190 Silom Road, Bangkok, 10500, Thailand

    Piyabuth Kittithamvongs

Authors
  1. Pritsanai Pruttikul
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  2. Wichayan Chobchai
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  3. Tinnakorn Pluemvitayaporn
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  4. Sombat Kunakornsawat
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  5. Chaiwat Piyaskulkaew
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  6. Piyabuth Kittithamvongs
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Corresponding author

Correspondence to Tinnakorn Pluemvitayaporn.

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Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Ethical approval

The study was approved by the ethics committee of Lerdsin Hospital.

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Pruttikul, P., Chobchai, W., Pluemvitayaporn, T. et al. Comparison of post-operative wound pain between interlaminar and transforaminal endoscopic spine surgery: which is superior?. Eur J Orthop Surg Traumatol 32, 909–914 (2022). https://doi.org/10.1007/s00590-021-03065-2

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  • DOI: https://doi.org/10.1007/s00590-021-03065-2

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