Full-endoscopic lumbar discectomy for lumbar disc herniation in young adults: 199 consecutive cases treated by a single surgeon with a mean 3.7-year follow-up.

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY Journal of neurosurgery. Spine Pub Date : 2024-06-28 Print Date: 2024-09-01 DOI:10.3171/2024.4.SPINE231011
Fei Feng, Rugang Zhao, Huajun Dong, Lingjia Yu, Yong Yang, Hai Tang, Xiaoguang Liu, Bin Zhu
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Abstract

Objective: Lumbar disc herniation (LDH) is rare in young adults. The present study aimed to evaluate the clinical outcomes of full-endoscopic lumbar discectomy (FELD) for LDH in young adults and to determine the risk factors that predict unfavorable outcomes of FELD for LDH in young adults.

Methods: A retrospective two-center cohort study was performed between January 2015 and October 2021 at the authors' institutions. Clinical outcomes were assessed using the visual analog scale (VAS) for low-back pain and leg pain and the Oswestry Disability Index (ODI). The modified Macnab criteria were used to evaluate clinical efficacy at the last follow-up, and the global outcomes were classified into 4 groups, namely excellent, good, fair, and poor. The fair and poor groups were defined as unfavorable outcomes.

Results: One hundred ninety-nine patients were analyzed in this study (mean age 18.5 years, mean BMI 25.1 kg/m2, male/female sex ratio 2.8). The duration from the onset of symptoms to the operation was in general prolonged with age. The VAS and ODI scores significantly improved after surgery. A total of 17 of 195 single-segment cases had unfavorable outcomes based on the modified Macnab criteria. Lateral disc herniation (OR 3.72, 95% CI 1.14-12.12, p = 0.029) and high preoperative VAS score (OR 1.98, 95% CI 1.13-3.46, p = 0.017) were identified as risk factors for unfavorable outcomes after FELD.

Conclusions: FELD for LDH in young adults is safe and effective. Preoperative VAS score and lateral disc herniation are risk factors of nonfavorable outcomes after surgery and may be a useful index for surgical procedure selection.

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全内窥镜腰椎间盘切除术治疗青壮年腰椎间盘突出症:由一名外科医生治疗的 199 例连续病例,平均随访 3.7 年。
目的:腰椎间盘突出症(LDH)在年轻人中很少见。本研究旨在评估全内窥镜腰椎间盘切除术(FELD)治疗青壮年腰椎间盘突出症的临床疗效,并确定预测全内窥镜腰椎间盘切除术治疗青壮年腰椎间盘突出症不良疗效的风险因素:作者所在机构在2015年1月至2021年10月期间进行了一项回顾性双中心队列研究。临床结果采用腰背痛和腿痛的视觉模拟量表(VAS)以及Oswestry残疾指数(ODI)进行评估。最后一次随访时,采用改良的 Macnab 标准评估临床疗效,并将总体疗效分为 4 组,即优、良、一般和差。结果:本研究分析了 199 名患者(平均年龄 18.5 岁,平均体重指数 25.1 kg/m2,男女性别比 2.8)。一般来说,随着年龄的增长,从症状出现到手术的持续时间会延长。术后 VAS 和 ODI 评分明显改善。根据改良的Macnab标准,195例单节段病例中,共有17例出现不良后果。外侧椎间盘突出(OR 3.72,95% CI 1.14-12.12,p = 0.029)和术前VAS评分高(OR 1.98,95% CI 1.13-3.46,p = 0.017)被认为是FELD术后不利预后的风险因素:结论:FELD治疗青壮年LDH安全有效。术前 VAS 评分和侧椎间盘突出是导致术后不良后果的风险因素,可能是选择手术方法的有用指标。
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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
期刊最新文献
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