[Percutaneous transforaminal endoscopic discectomy combined with Coflex interspinous process dynamic reconstruction system in treatment of youth lumbar disc herniation].

OBJECTIVE

To evaluate the effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) combined with Coflex interspinous process dynamic reconstruction system for the treatment of youth lumbar disc herniation (LDH).

METHODS

The clinical data of 52 patients with LDH treated by PTED combined with Coflex were retrospectively analyzed between February 2013 and March 2015. The involved segments were L in 30 cases and L , S in 22 cases. In 30 patients at L level, there were 18 males and 12 females with an average age of 25 years (range, 18-34 years) and a mean disease duration of 10 months (range, 6-16 months). In 22 patients at L , S level, there were 10 males and 12 females with an average age of 25.5 years (range, 19-32 years) and a mean disease duration of 12 months (range, 6-18 months). The operation time and intraoperative blood loss were recorded. Oswestry disability index (ODI) and Japanese Orthpoaedic Association (JOA) score were used for effectiveness assessment. Radiograpic indexes were calculated on X-ray films before operation and final follow-up, including ventral intervertebral space height (VH), dorsal intervertebral space height (DH), intervertebral foramen height (IFH), the range of motion (ROM) of involved segment, and the ROM of upper adjacent segment.

RESULTS

The operations were successfully completed in 52 patients. The operation time and intraoperative blood loss were (89.7±16.5) minutes and (42.7±11.3) mL in patients at L level, and were (94.6±18.2) minutes and (47.6±13.4) mL in patients at L , S level. Incisions healed by first intention. All patients were followed up 12-18 months (mean,16 months) in patients at L level and 12-20 months (mean, 17 months) in patients at L , S level. At final follow-up, ODI, and JOA score were significantly improved when compared with preoperative ones in all patients ( <0.05). X-ray films showed no complication of Coflex loosening, spinous process fracture, or articular process fracture occurred. At final follow-up, VH, DH, and IFH were significantly improved when compared with preoperative ones in all patients ( <0.05), and the ROM of involved segment was significantly reduced compared with preoperative one ( <0.05), but the ROM of upper adjacent segment showed no significant difference when compared with preoperative one ( >0.05).

CONCLUSION

PTED combined with Coflex is a safe and effective minimally invasive surgery in treating youth LDH; however, it still needs further clinical studies.