Prognostic factors for patient-reported satisfaction after percutaneous lumbar endoscopic discectomy at a minimum of two years’ follow-Up

Percutaneous endoscopic lumbar discectomy (PELD) is increasingly used in patients with lumbar disc herniation due to its less invasive nature and faster recovery. In this study, we aimed to investigate the prognostic factors associated with patient satisfaction index (PSI) in PELD. A retrospective study of 337 patients who underwent PELD between November 2015 and October 2020 in our department was conducted. Preoperative data of the enrolled patients were recorded. A logistic regression model was developed to explore the preoperative factors associated with postoperative PSI. After a mean follow-up of 28.7 ± 3.6 months, 310 patients were satisfied (NASS score of 1 or 2) and 27 patients were dissatisfied (NASS score of 3 or 4), resulting in a patient satisfaction rate of 91.99%. Demographic data, clinical symptom characteristics, and neurological physical examinations (including lower limb hypesthesia, muscle strength, and tendon flex) did not show any significant differences between the four groups (NASS1,2,3,4). The satisfactory group showed a higher rate of positive Lasegue sign (P = 0.010) and higher preoperative VAS (P = 0.002). The dissatisfaction group showed a higher rate of contiguous double-level disc herniation (P = 0.003). Our findings indicated that positive Lasegue sign and high preoperative VAS were prognostic factors for patient-reported satisfaction and PELD might not be the first choice for contiguous double-level disc herniation.