Article Figures & Data
Figures
- Figure 1
Representation of VAS back scores preoperatively and at various follow-up intervals for (A) patients younger than 70 years and (B) patients aged 70 years or older. Significant (“*” denotes P < 0.05; “**” denotes P < 0.01; “***” denotes P < 0.001) and nonsignificant values (denoted by “ns”) comparing the preoperative score to each of the follow-up time points are visually represented. Additional statistically significant values were noted for group (A) between “day 1” and “day 4” (P < 0.01); “day 1” and “1 week” (P < 0.001); “day 1” and “2 weeks” (P < 0.001); “day 1” and “3 months” (P < 0.001); “day 4” and “2 weeks” (P < 0.001); “day 4” and “3 months” (P < 0.001); “1 week and 2 weeks” (P < 0.01); “1 week” and “3 months” (P < 0.001) as well as for group (B) between “day 1” and “2 weeks” (P < 0.01); “day 1” and “3 months” (P < 0.05); “day 4” and “2 weeks” (P < 0.05).
- Figure 2
Representation of visual analog scale (VAS) ipsilateral leg scores preoperatively and at various follow-up intervals for (A) patients younger than 70 years and (B) patients aged 70 years or older. Significant (“*” denotes P < 0.05; “**” denotes P < 0.01; “***” denotes P < 0.001) and nonsignificant values (denoted by “ns”) comparing the preoperative score to each of the follow-up time points are visually represented. Additional statistically significant values were noted for group (A) between “day 1” and “3 months” (P < 0.01); “day 4” and “2 weeks” (P < 0.01); “day 4” and “3 months” (P < 0.001); “1 week” and “3 months” (P < 0.001) as well as for group (B) between “day 4” and “3 months” (P < 0.05).
- Figure 3
Representation of Oswestry Disability Index (ODI) scores preoperatively and at various follow-up intervals for (A) patients less than 70 years old and (B) patients greater than or equal to 70 years old. Significant (“*” denotes P < 0.05; “**” denotes P < 0.01; “***” denotes P < 0.001) and nonsignificant values (denoted by “ns”) comparing the preoperative score to each of the follow-up time points are visually represented. Additional statistically significant values were noted for group (A) between “day 1” and “1 week” (P < 0.001); “day 1” and “2 weeks” (P < 0.001); “day 1” and “3 months” (P < 0.001); “day 4” and “1 week” (P < 0.05); “day 4” and “2 weeks” (P < 0.001); “day 4” and “3 months” (P < 0.001); “1 week” and “2 weeks” (P < 0.001); “1 week” and “3 months” (P < 0.001); “2 weeks” and “3 month” (P < 0.001) as well as for group (B) between “day 1” and “3 months” (P < 0.001); “day 4” and “3 months” (P < 0.001); “1 week” and “3 months” (P < 0.001); “2 weeks” and “3 months” (P < 0.01).
Tables
- Table 1
Demographic, medical history, and procedure details for the total patient cohort and groups stratified by age.
Patient Characteristics Total Cohort
(N = 164)Age <70 y
(N = 125)Age ≥70 y
(N = 39)P q a Demographic and Physical Details Sex, n/N (%) 0.404b 0.628 Men 100/164 (61%) 74/125 (59%) 26/39 (67%) Women 64/164 (39%) 51/125 (41%) 13/39 (33%) Age, median (IQR) 58.0 (44.8–69.0) 52.0 (40.0–61.0) 75.0 (72.0–76.5) <0.001c <0.001 Race, n/N (%) 0.648d 0.811 White 87/101 (86%)e 73/84 (87%)e 14/17 (82%)e Black or African American 8/101 (8%)e 6/84 (7%)e 2/17 (12%)e American Indian or Alaska Native 1/101 (1%)e 1/84 (1%)e 0/17 (0%)e Asian 2/101 (2%)e 2/84 (2%)e 0/17 (0%)e Self-reported unknown 3/101 (3%)e 2/84 (2%)e 1/17 (6%)e Ethnicity, n/N (%) 0.385d 0.628 Not Hispanic or Latino 78/101 (77%)e 66/84 (79%)e 12/17 (71%)e Hispanic or Latino 18/101 (18%)e 13/84 (15%)e 5/17 (29%)e Self-reported unknown 5/101 (5%)e 5/84 (6%)e 0/17 (0%)e Current smoker, n/N (%) 8/127 (6%)e 8/94 (9%)e 0/33 (0%)e 0.111d 0.415 BMI (kg/m2), median (IQR) 29.2 (25.8–33.7)e 29.2 (25.8–35.1)e 29.0 (25.9–32.1) 0.372c 0.628 Medical History Diabetes, n/N (%) 23/164 (14%) 16/125 (13%) 7/39 (18%) 0.419b 0.628 Hypertension, n/N (%) 64/164 (39%) 36/125 (29%) 28/39 (72%) <0.001b <0.001 Hyperlipidemia, n/N (%) 16/164 (10%) 8/125 (6%) 8/39 (21%) 0.025d 0.126 Arthritis, n/N (%) 26/164 (16%) 22/125 (18%) 4/39 (10%) 0.273b 0.628 Asthma, n/N (%) 9/164 (5%) 7/125 (6%) 2/39 (5%) >0.999d >0.999 Chronic lung disease, n/N (%) 3/164 (2%) 2/125 (2%) 1/39 (3%) 0.560d 0.763 Heart attack, n/N (%) 2/164 (1%) 2/125 (2%) 0/39 (0%) >0.999d >0.999 Congestive heart failure, n/N (%) 1/164 (1%) 1/125 (1%) 0/39 (0%) >0.999d >0.999 Coronary artery disease, n/N (%) 3/164 (2%) 1/125 (1%) 2/39 (5%) 0.141d 0.423 Procedure Details Procedure type, n/N (%) Discectomy 90/164 (55%) 82/125 (66%) 8/39 (21%) <0.001b <0.001 TELD 51/164 (31%) 46/125 (37%) 5/39 (13%) 0.005b 0.019 IELD 38/164 (23%) 35/125 (28%) 3/39 (8%) 0.009b 0.029 EELD 1/164 (1%) 1/125 (1%) 0/39 (0%) >0.999d >0.999 Other decompression 74/164 (45%) 43/125 (34%) 31/39 (79%) <0.001b <0.001 LE-ULBD 57/164 (35%) 34/125 (27%) 23/39 (59%) <0.001b 0.002 IE-LRD 8/164 (5%) 3/125 (2%) 5/39 (13%) 0.019d 0.055 TELF 6/164 (4%) 3/125 (2%) 3/39 (8%) 0.147d 0.326 ICELF 2/164 (1%) 2/125 (2%) 0/39 (0%) >0.999d >0.999 TE-LRD 1/164 (1%) 1/125 (1%) 0/39 (0%) >0.999d >0.999 Levels of operation,f n/N (%) L1/2 7/164 (4%) 3/125 (2%) 4/39 (10%) 0.056d 0.139 L2/3 18/164 (11%) 8/125 (6%) 10/39 (26%) 0.002d 0.010 L3/4 28/164 (17%) 21/125 (17%) 7/39 (18%) 0.868b >0.999 L4/5 97/164 (59%) 73/125 (58%) 24/39 (62%) 0.728b 0.970 L5/S1 42/164 (26%) 35/125 (28%) 7/39 (18%) 0.209b 0.419 Surgical approach, n/N (%) 0.231b 0.421 Right 83/164 (51%) 60/125 (48%) 23/39 (59%) Left 81/164 (49%) 65/125 (52%) 16/39 (41%) Revision surgery, n/N (%) 36/164 (22%) 28/125 (22%) 8/39 (21%) 0.804b >0.999 Dural tear, n/N (%) 4/113 (4%)e 3/94 (3%)e 1/19 (5%)e 0.526d 0.752 Procedure duration (min), median (IQR) 90.0 (60.0–120.0) 88.0 (60.0–120.0) 90.0 (67.5–120.0) 0.350c 0.583 Blood loss (mL), median (IQR) 5.0 (5.0–10.0) 5.0 (5.0–10.0) 5.0 (5.0–10.0) 0.384c 0.591 Abbreviations: BMI, body mass index; EELD, extraforaminal endoscopic lumbar discectomy; ICELF, interlaminar contralateral endoscopic lumbar foraminotomy; IELD, interlaminar endoscopic lumbar discectomy; IE-LRD, interlaminar endoscopic lateral recess decompression; IQR, interquartile range; LE-ULBD, lumbar endoscopic unilateral laminotomy for bilateral decompression; TELD, transforaminal endoscopic lumbar discectomy; TELF, transforaminal endoscopic lumbar foraminotomy; TE-LRD, transforaminal endoscopic lateral recess decompression.
Note: Boldface indicates statistical significance (p < 0.05).
↵a False discovery rate correction for multiple testing (corrections for “Demographic and Physical Details” and “Medical History” were performed independently from “Procedure Details”).
↵b Pearson’s χ 2 test.
↵c Wilcoxon rank sum test.
↵d Fisher’s exact test.
↵e Denominator was adjusted to account for missing values.
↵f Levels of operation may span >1 spinal region; therefore, percentages sum to >100%.
Outcome Measure Total Cohort
(N = 164)Age <70 y
(N = 125)Age ≥70 y
(N = 39)P VAS Back Outcomes, median (IQR) Preoperative 6.0 (4.0–7.5) 6.0 (4.5–7.5) 5.1 (3.3–7.0) 0.060a ΔDay 1 1.5 (–0.5 to 3.6) 1.3 (-0.5–3.5) 1.5 (–0.8–3.5) 0.855b ΔDay 4 2.0 (0.0–4.5) 2.0 (0.0–4.5) 1.5 (–0.3–4.9) 0.658b Δ1 week 2.5 (0.5–4.5) 2.5 (0.5–4.6) 2.5 (0.0–4.2) 0.872b Δ2 week 3.0 (1.0–5.0) 3.0 (1.0–5.5) 2.1 (1.0–4.8) 0.699b Δ3 month 3.4 (0.8–5.8) 3.5 (1.0–6.0) 2.4 (0.0–5.3) 0.199a VAS Ipsilateral Leg Outcomes, median (IQR) Preoperative 6.2 (4.0–8.0) 6.4 (4.5–8.0) 5.5 (2.0–8.0) 0.140a ΔDay 1 3.5 (1.0–6.4) 3.5 (1.0–6.0) 3.0 (0.0–6.8) 0.780b ΔDay 4 3.5 (1.0–6.0) 3.5 (1.5–6.0) 2.5 (0.0–6.4) 0.547a Δ1 week 3.5 (1.0–6.0) 3.5 (1.5–6.0) 2.5 (0.3–6.8) 0.580a Δ2 weeks 3.9 (1.5–6.0) 4.0 (2.0–6.0) 2.0 (0.0–6.3) 0.135a Δ3 months 4.2 (2.0–7.0) 4.3 (2.9–6.5) 3.5 (0.0–7.4) 0.428a ODI Outcomes, median (IQR) Preoperative 20.3 (15.2–26.3) 20.3 (15.5–27.0) 20.0 (14.8–24.5) 0.248a ΔDay 1 –0.9 (–7.1–7.6) –1.8 (–8.0–8.0) 1.0 (–5.4–5.0) 0.621a ΔDay 4 –1.0 (–6.1–8.0) 0.0 (–6.3–9.0) –2.3 (–5.0–6.1) 0.325b Δ1 week 1.8 (–5.0–9.7) 2.0 (–5.0–10.5) 1.0 (–5.0–7.5) 0.405b Δ2 weeks 4.3 (–3.0–10.1) 5.0 (–2.3–11.5) 4.0 (–4.5–6.6) 0.099a Δ3 months 11.3 (4.9–18.1) 12.0 (5.3–19.0) 8.3 (3.4–15.3) 0.158b Perceived Surgical Outcome at 3 mo, n/N (%) 0.623c Good 130/164 (79%) 98/125 (78%) 32/39 (82%) Poor 34/164 (21%) 27/125 (22%) 7/39 (18%) Abbreviations: IQR, interquartile range; ODI, Oswestry Disability Index; VAS, visual analog scale.
Note: “Δ” Values are reported as the median change in score from preoperative evaluation to the indicated follow-up time point. Positive values represent an improvement and negative values represent a decline.
↵a Wilcoxon rank sum test.
↵b Two sample t test.
↵c Pearson’s χ 2 test.
- Table 3
Postoperative patient outcomes stratified by perceived surgical outcome at 3 months.
Outcome Measure Good
(N = 130)Poor
(N = 34)P q a VAS Back Outcomes, median (IQR) Preoperative 6.0 (4.0–7.4) 6.0 (5.0–7.8) 0.243b 0.547 ΔDay 1 1.5 (–0.9–3.7) 1.1 (–0.1–3.2) 0.893c 0.966 ΔDay 4 2.0 (0–4.5) 2.2 (0–4.6) 0.953d 0.966 Δ1 week 2.5 (0.5–5.0) 2.5 (1.1–4.0) 0.864c 0.966 Δ2 weeks 3.0 (1.0–5.0) 3.0 (1.0–4.7) 0.890d 0.966 Δ3 months 3.5 (1.0–6.0) 1.7 (–0.7–3.9) 0.002b 0.009 VAS Ipsilateral Leg Outcomes, median (IQR) Preoperative 6.3 (4.0–8.0) 6.0 (4.1–8.0) 0.966b 0.966 ΔDay 1 3.8 (1.0–6.5) 2.5 (0–6.0) 0.170b 0.437 ΔDay 4 3.6 (1.0–6.0) 3.0 (–0.6–6.3) 0.334b 0.547 Δ1 week 3.6 (1.5–6.5) 2.5 (–0.4–4.4) 0.016b 0.058 Δ2 weeks 4.0 (2.0–6.5) 1.5 (–0.8–4.4) 0.002b 0.009 Δ3 months 4.5 (2.9–7.2) 2.5 (–0.9–5.1) 0.001b 0.009 ODI Outcomes, median (IQR) Preoperative 20.2 (15.1–26.0) 20.1 (16.1–28.0) 0.320d 0.547 ΔDay 1 0 (–6.0–7.7) –2.5 (–10.8–5.8) 0.562d 0.806 ΔDay 4 –1.0 (–5.7–7.8) 0 (–9.0–8.2) 0.582d 0.806 Δ1 week 2.8 (–3.9–9.9) 0.9 (–7.9–8.8) 0.294d 0.547 Δ2 weeks 5.0 (–2.8–11.2) 2.1 (–4.9–7.6) 0.090b 0.270 Δ3 months 12.1 (6.8–19.0) 4.1 (–2.5–10.2) <0.001d <0.001 Abbreviations: IQR, interquartile range; VAS, visual analog scale.
Note: “Δ” Values are reported as the median change in score from preoperative evaluation to the indicated follow-up time point. Positive values represent an improvement and negative values represent a decline. Boldface indicates statistical significance (p < 0.05).
↵a False discovery rate correction for multiple testing.
↵b Wilcoxon rank sum test.
↵c Welch’s t test.
↵d Two sample t test.
FIGURE S1.
TABLE S1.
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