2.1. Patients
intervertebral disc herniation, anxiety/depression, low back pain-related disability, urination or defecation, pain, infection, neoplasm, disability, NRS
INFECTION, INTERVERTEBRAL DISC HERNIATION, NEOPLASM, BLEEDING DIATHESIS
Between January 2016 and June 2021, we enrolled 470 patients who underwent ELD. These patients were between the ages of 18 to 80 years old and were classified according to their physical status using the American Society of Anesthesiology grading system (classes I, II, and III) (Fig. Flow chart of patient selection, enrollment, and follow-up in the study.Inclusion criteria for the study were: being 18 years old or older, having signed informed consent, presenting with magnetic resonance imaging evidence of intervertebral disc herniation or sequestration, and experiencing permanent pain radiating to the lower limbs despite prior epidural steroid injection or similar interventions in conjunction with conservative treatment (such as rehabilitation and pharmacological treatment).Exclusion criteria were: bleeding diathesis, urination or defecation problems, presence of infection or neoplasm, possible pregnancy, and patient disapproval. The procedure was performed by either a spine surgeon or an interventional pain management specialist, and each patient received a unique clinical trial ID number.The primary outcomes of the study were the intensity of pain radiating to the back and legs, measured using the numerical rating scale (NRS) (ranging from 0 to 10), and the evaluation of the ODI, which assesses the extent of low back pain-related disability on a scale of 0 to 100%. Scores between 0 and 20% indicate minimal disability, while scores between 81 and 100% indicate bedridden patients or those with exaggerated symptoms. We also assessed the EuroQol survey using the EQ-5D-5L questionnaire. The descriptive system consists of five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, with scores ranging from 1 to 5 (representing the best to worst state). The EuroQol survey also includes the EQ-VAS vertical visual analog scale, which utilizes a grading scale from 0 to 100 to evaluate the quality of life. A score of 0 indicates “The worst health you can imagine,” while a score of 100 indicates “The best health you can imagine.”No significant changes were made to the methods after the study commenced. Prior to the operation, the NRS for back and leg pain, EQ-VAS, and ODI were assessed in one of the pain clinics participating in the study. The second assessment was conducted 12 months after the procedure, either during an appointment in one of the included centers or via a phone call follow-up, to assess pain severity by NRS and neurological state.