Department of Orthopedics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China (mainland).
Med Sci Monit. 2020 Jan 26;26:e918619. doi: 10.12659/MSM.918619.
BACKGROUND Annular fiber closure techniques have been proven effective in reducing short-term recurrence after discectomy. However, annular fiber closure devices are expensive and still fail at a low rate. We present a novel suture method, needle-guided annular closure suture (NGACS) that does not require a special device and can be performed for annular fiber closure following microendoscopic discectomy. MATERIAL AND METHODS Twenty-five patients who underwent treatment with NGACS were reviewed by analysis of the medical records. The clinical outcomes were assessed and compared preoperatively and immediately, 1, 6, and 12 months postoperatively. The parameters included the Visual Analog Scale (VAS)-back and VAS-leg scores and the Oswestry Disability Index (ODI). Midsagittal T2WI images were obtained to evaluate lumbar disc degeneration using the Pfirrmann grade. Additional adverse events were also recorded and tracked. RESULTS The VAS-back and VAS-leg scores and the ODI were significantly different at each follow-up time point (P<0.001), and improvements in pain and disability were maintained well during the follow-up period. Lumbar disc reherniation or other serious adverse events were not observed in this series. There was no significant difference between the initial and final Pfirrmann grades (Z=-1.414, P=0.157). The preoperative average disc height was 9.94±1.97 mm, and the disc height at 12 months after surgery was 9.14±1.88 mm. The average decrease in disc height was 8.11±3.36%. CONCLUSIONS This study demonstrates the feasibility and superior clinical outcomes of the NGACS technique. This method can be a good substitution when annular fiber closure devices are not available. Moreover, this technique can be easily popularized due to its low cost and few restrictions.
环形纤维闭合技术已被证明可有效降低椎间盘切除术后的短期复发率。然而，环形纤维闭合装置昂贵，且仍有低比例的失败率。我们提出了一种新的缝合方法，即针引导的环形闭合缝合（NGACS），该方法不需要特殊设备，可在微创椎间盘切除术后进行环形纤维闭合。
对 25 例接受 NGACS 治疗的患者进行病历分析。通过术前、术后即刻、1、6 和 12 个月的评估和比较来评估临床结果。评估参数包括视觉模拟量表（VAS）-背部和 VAS-腿部评分以及 Oswestry 功能障碍指数（ODI）。获得正中矢状面 T2WI 图像，使用 Pfirrmann 分级评估腰椎间盘退变。还记录并跟踪了其他不良事件。
在每个随访时间点，VAS-背部和 VAS-腿部评分以及 ODI 均有显著差异（P<0.001），在随访期间疼痛和残疾的改善保持良好。在本系列中未观察到腰椎间盘再突出或其他严重不良事件。初始和最终 Pfirrmann 分级之间无显著差异（Z=-1.414，P=0.157）。术前平均椎间盘高度为 9.94±1.97mm，术后 12 个月椎间盘高度为 9.14±1.88mm。椎间盘高度平均下降 8.11±3.36%。
本研究证明了 NGACS 技术的可行性和优越的临床结果。当环形纤维闭合装置不可用时，该方法可以作为一种良好的替代方法。此外，由于该技术成本低且限制少，因此易于推广。
