Percutaneous Endoscopic Interlaminar Discectomy For Lumbar Disc: Early Experience, Outcome and Complication: a Retrospective Observational Study With a Pre–Post Design
This retrospective observational study of 41 patients at H. Adam Malik General Hospital demonstrates that Percutaneous Endoscopic Interlaminar Discectomy (PEID) is a safe and effective minimally invasive treatment for lumbar disc herniation, significantly reducing pain and improving physical function with a low complication rate.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Imagine your spine is a high-tech, multi-story apartment building. Between each floor (the vertebrae) sits a squishy, jelly-filled cushion called a disc. Sometimes, that jelly gets squeezed out of its casing and pokes a hole in the wall, pressing on the "wires" (nerves) that run down your legs. This is a lumbar disc herniation, and it can turn your life into a constant, painful buzz.
For decades, the standard fix was like sending in a demolition crew: a big open surgery to cut through muscles and bone to reach the problem. But a team of surgeons in Medan, Indonesia, decided to try something more like a "ghost hunter" approach. They used a technique called Percutaneous Endoscopic Interlaminar Discectomy (PEID). Think of this as sending a tiny, high-definition camera and a miniature vacuum cleaner through a tiny keyhole in the back, rather than tearing the whole door off.
The Mission and the Team
Between January 2020 and December 2024, the team at H. Adam Malik General Hospital invited 41 adult volunteers who were suffering from this "jelly leak" at just one level of their spine. The average age of the group was 40.37 years, and they were almost evenly split between men and women (21 men and 20 women).
The surgeons didn't just guess; they used a specific tool kit. They made a tiny 10 mm cut (about the width of a thick marker) near the middle of the back. Through this, they slid a working sleeve and a camera with a 6mm channel. If the "window" between the bones was too tight, they used a tiny drill to widen it just enough to slip the camera in. Once inside, they gently moved the nerve aside, cut away the herniated jelly, and used a radiofrequency wand to cauterize (seal) the remaining disc tissue so it wouldn't leak again.
The Results: A Quick Turnaround
The study looked at two main things: how much it hurt (measured by a Visual Analog Score, or VAS, where higher numbers mean more pain) and how hard it was to do daily tasks (measured by the Oswestry Disability Index, or ODI).
Before the surgery, the patients were in serious pain, with an average VAS of 7.68. After just three months, that number dropped significantly to 5.34. That's a big difference! The paper notes this change was statistically significant, meaning it wasn't just luck.
The disability scores told an even more dramatic story. Before the operation, the average ODI score was 57.07, indicating a lot of trouble with daily life. Three months later, that number plummeted to 21.95. The authors suggest this means the surgery successfully helped people get back to moving around without as much struggle.
The whole procedure was surprisingly quick, taking an average of 56.34 minutes per patient.
The "Oops" Moments
No medical adventure is without a few bumps in the road. In this group of 41, only 2 patients (about 4.9%) had a complication. One specific issue mentioned was a "durotomy," which is like accidentally poking a tiny hole in the water balloon surrounding the spinal cord. In one case, the surgeons had to swap their camera for a smaller one and use a special glue and muscle patch to seal the leak. But for the other 39 patients (95.1%), everything went smoothly with no complications.
What the Paper Says (and Doesn't Say)
The authors are careful to point out that while these results look great, this study has some limits. They explicitly state that because they looked back at old records (a retrospective study) and only had 41 people from one hospital, they can't claim this is the "final answer" for everyone. They didn't have a control group to compare against the old "demolition crew" surgery, so they can't say for sure that PEID is better than the big surgery, only that it works well on its own.
They also note that they only checked the patients for three months. They don't know yet if the pain will stay away for years or if the "jelly" will leak out again later. The paper suggests that PEID is a strong option, especially for tricky spots like the L5-S1 level where other methods might struggle, but it admits that more research with bigger groups and longer follow-ups is needed to be absolutely certain.
The Bottom Line
In simple terms, this study suggests that using a tiny camera to fix a slipped disc is a safe and effective way to reduce pain and help people move better, with a very low chance of things going wrong. It's a promising "keyhole" solution that avoids the big mess of traditional surgery, though the authors remind us that the story isn't fully written yet.
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