Percutaneous Endoscopic Lumbar Discectomy Using a Double‐Cannula Guide Tube for Large Lumbar Disc Herniation

Objective To compare the effect of percutaneous endoscopic lumbar discectomy (PELD) using a double‐cannula guide tube (DGT), traditional PELD, and open lumbar discectomy (OLD) to treat large lumbar disc herniations (LLDHs). Methods Seventy patients who presented with LLDH without cauda equina syndrome and were treated with surgery in our hospital from October 2015 to October 2017 were included. The detailed index included the visual analog scale (VAS) for back and radicular leg pain and the Oswestry Disability Index (ODI) in the immediate preoperative period and at the final follow‐up. The operation time, radiation exposure time, surgical satisfaction rate, and modified MacNab criteria score were also recorded. Results The leg and back pain of the patients in these groups improved significantly in the postoperative period. No significant differences were observed in leg pain improvement between the other two groups; however, patients in the PELD group (with or without DGT) presented with significantly higher improvement in back pain than the OLD group (t = 9.965, p