• Amir Saied Seddighi, Afsoun Seddighi, and Seyedmorteza Hosseini.
• Shohada Tajrish Neurosurgical Center of Excellence, Functional Neurosurgery Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
• World Neurosurg. 2024 Nov 22; 194: 123392123392.

BackgroundThis 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.MethodsIn 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.ResultsNo 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.ConclusionsThis 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.Copyright © 2024 Elsevier Inc. All rights reserved.

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