Nakamae Toshio, Fujimoto Yoshinori, Yamada Kiyotaka, Nakanishi Kazuyoshi, Kamei Naosuke, Yoshizaki Ken, Adachi Nobuo
Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
J Orthop Sci. 2019 Nov;24(6):1015-1019. doi: 10.1016/j.jos.2019.07.019. Epub 2019 Aug 23.
Percutaneous endoscopic discectomy (PED) has been reported to be less invasive and effective procedure for lumbar disc herniation (LDH). Damage to the back muscle is considered minimal, which is particularly important for athletes. However, the results of PED for LDH in athletes have not been reported well. The purpose of this study was to evaluate the clinical outcomes of PED for LDH in athletes.
We retrospectively analyzed 21 athlete patients with LDH who had undergone PED. All patients received athletic rehabilitation immediately after surgery. The clinical outcomes were evaluated from the visual analogue scale (VAS) for leg pain and low back pain (LBP), the Oswestry Disability Index (ODI), complications and periods of return to sport.
There were 18 men and 3 women, and the mean age at the time of surgery was 22.9 years (range: 15-43 years). The mean VAS scores for leg pain before and after surgery were 64.3 ± 2.7 mm and 12.4 ± 1.4 mm, respectively. The mean VAS scores for LBP before and after surgery were 62.1 ± 2.2 mm and 10.5 ± 1.1 mm, respectively. The mean ODI scores before and after surgery were 31.3 ± 14.0% and 14.6 ± 7.1%, respectively. The VAS for leg pain, as well as the LBP and ODI, significantly improved after surgery. There were no complications related to the surgery. Ninety-five percent (20/21) returned to play sports at the same performance level as before the procedure by an average of 9.2 weeks after PED.
PED is a minimally invasive and effective procedure for patients with LDH, especially in athletes. Not only the patients' leg pain but also their discogenic LBP improved. PED has the benefits of preservation of normal posterior structures and a faster return to sports.
经皮内镜下椎间盘切除术（PED）已被报道为治疗腰椎间盘突出症（LDH）的一种侵入性较小且有效的手术。对背部肌肉的损伤被认为极小，这对运动员尤为重要。然而，关于PED治疗运动员LDH的结果尚未有充分报道。本研究的目的是评估PED治疗运动员LDH的临床疗效。
我们回顾性分析了21例接受PED治疗的LDH运动员患者。所有患者术后立即接受运动康复治疗。从腿痛和腰痛（LBP）的视觉模拟量表（VAS）、Oswestry功能障碍指数（ODI）、并发症以及恢复运动的时间来评估临床疗效。
有18名男性和3名女性，手术时的平均年龄为22.9岁（范围：15 - 43岁）。术前和术后腿痛的平均VAS评分分别为64.3±2.7毫米和12.4±1.4毫米。术前和术后LBP的平均VAS评分分别为62.1±2.2毫米和10.5±1.1毫米。术前和术后的平均ODI评分分别为31.3±14.0%和14.6±7.1%。术后腿痛的VAS以及LBP和ODI均显著改善。没有与手术相关的并发症。95%（20/21）的患者在PED术后平均9.2周后恢复到与手术前相同的运动水平。
PED对于LDH患者，尤其是运动员，是一种微创且有效的手术。不仅患者的腿痛得到改善，而且其椎间盘源性LBP也有所改善。PED具有保留正常后部结构和更快恢复运动的优点。
