Haijun Ma, Mingkui Shen, Zhongxin Tang, Kuankuan Li, Honggang Zhou, Xiao Sun, Zhaochen Zhou, Jun Tan
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Abstract
Purpose: This study aimed to assess the clinical effectiveness and safety of percutaneous endoscopic interlaminar discectomy (PEID) in the management of high-grade migrated Lumbar disc herniation (LDH).
Methods: A total of 328 patients who underwent PEID for high-grade migrated LDH between May 2020 and January 2023 in our hospital were selected. Patients were categorized into high-grade migrated group and low-grade migrated group according to preoperative MRI findings. The preoperative and postoperative evaluations of clinical outcomes, such as Visual Analogue Scale (VAS) for lower backs and legs, Oswestry Disability Index (ODI), and modified MacNab criteria for surgical success, were compared between groups.
Results: No statistically significant differences were found in hospitalization time, surgery time, intraoperative hemorrhage, number of intraoperative fluoroscopies, or incision length between the two groups. The lower back and leg VAS scores and ODI exhibited a statistically significant decrease in both groups across all postoperative time intervals. However, the difference between the two groups was not statistically significant. Postoperative nerve root stimulation symptoms were reported in two and three cases in the high-grade migrated group and low-grade migrated group, respectively. One patient in the high-grade migrated group underwent reoperation due to re-herniation at the same segment. There was no significant difference in the rate of excellent-good cases between the two groups, with an overall rate of 94.7%.
Conclusion: In treating high-grade migrated disc herniation, PEID offers advantages such as reduced trauma, small incision, quicker recovery and satisfactory clinical safety and efficacy.
目的：本研究旨在评估经皮内镜下椎间孔镜椎间盘切除术（PEID）治疗高位移位性腰椎间盘突出症（LDH）的临床有效性和安全性：方法：选取2020年5月至2023年1月期间在我院接受经皮内镜下椎间孔镜椎间盘切除术（PEID）治疗高级别移位腰椎间盘突出症的328例患者。根据术前磁共振成像结果将患者分为高级别移行组和低级移行组。比较两组患者术前和术后的临床效果评估，如腰部和腿部的视觉模拟量表（VAS）、Oswestry残疾指数（ODI）以及手术成功的改良MacNab标准：结果：两组患者在住院时间、手术时间、术中出血量、术中透视次数和切口长度方面均无统计学差异。在所有术后时间间隔内，两组患者的腰部和腿部 VAS 评分及 ODI 均有统计学意义的显著下降。然而，两组之间的差异并无统计学意义。高位移位组和低位移位组分别有两例和三例患者出现术后神经根刺激症状。高级别移位组中有一名患者因同一节段再次发生疝气而接受了再次手术。两组患者的优良率无明显差异，总优良率为94.7%：结论：在治疗高位椎间盘突出症时，PEID具有创伤小、切口小、恢复快、临床安全性和疗效满意等优点。
期刊介绍：
International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters.
Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable.
The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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