PhD defence P.S. (Pravesh) Gadjradj

Below is a brief summary of the dissertation:

Keyhole surgery known as PTED is at least as effective as standard surgery for a herniated disc. In addition, PTED surgery saves nearly €2,800 in social costs. This is the conclusion reached by researchers at Erasmus MC in a large study conducted in collaboration with LUMC, Park Medical Center, Rijnstate, and VU University Amsterdam. PTED stands for Percutaneous Transforaminal Endoscopic Discectomy. This involves inserting a narrow tube with a camera through a small incision on the side of the back. The herniated disc can then be removed through the opening between two vertebrae. This is done under local anesthesia.

PTED is a less invasive operation for patients, who can return home a few hours after treatment. The study showed that PTED surgery is at least as effective as standard surgery.

Back to work faster
The researchers also showed that each PTED operation, which costs the same as the traditional operation, saves almost €2,800 in social costs. Patients who have undergone PTED surgery recover faster, require less pain medication and physiotherapy, and can return to work sooner.

The study was published in the British Medical Journal and the British Journal of Sports Medicine. The researchers conducted the PTED study between February 2016 and April 2019 among 613 people with a herniated disc.

Insurance coverage
PTED has now been included in the health care package to be reimbursed for adults with persistent leg complaints caused by a lower back hernia. For the time being, reimbursement only applies if the operation is performed by surgeons who have successfully participated in the conditional admission process. These surgeons work at Rijnstate Hospital (Arnhem), Rijnland Hospital (Leiderdorp), Park Medical Center (Rotterdam), and St. Elisabeth Hospital (Tilburg).