Clinical Outcomes at 2-Year Follow-Up Comparing Open Surgery and Percutaneous Laser Disc Decompression for Radicular Sciatic Pain Patients.

Background: This study aims to compare the clinical outcomes of percutaneous laser disc decompression (PLDD) and open surgery for patients with radicular sciatic pain caused by lumbar disc herniation over a 2-year follow-up period.

Methods: In a prospective randomized controlled trial, 84 patients with chronic radicular pain were assigned to either the open surgery group (n = 42) or the PLDD group (n = 42). Patients were evaluated at baseline, and at 4, 8, 24, 48, and 96 weeks postintervention. Outcome measures included the Roland-Morris Disability Questionnaire, Visual Analog Scale for leg and back pain, and the Short Form-36 bodily pain and physical functioning subscales. Resurgery rates were also recorded.

Results: No significant differences in Roland-Morris Disability Questionnaire, Visual Analog Scale for leg and back pain, or Short Form-36 scores were observed between the 2 groups at any follow-up time points. Both groups showed improvement in disability and pain scores over time, with similar patterns of recovery. The median resurgery rates were 19.0% for open surgery and 31.0% for PLDD (P = 0.314), indicating comparable long-term effectiveness of both treatments.

Conclusions: This study demonstrates that PLDD and open surgery provide similar long-term outcomes in terms of disability, pain relief, and physical functioning for patients with radicular sciatic pain. While PLDD is associated with a higher resurgery rate, it remains a viable minimally invasive alternative to open surgery. Further research is warranted to refine patient selection criteria and improve procedural efficacy for both interventions.