Department of Orthopedics, Guangzhou Hospital of Integrated Traditional and Western Medicine, 87 Yingbin Avenue, Huadu District, Guangzhou City, Guangdong Province, People's Republic of China.
Department of Surgery, Xinhua Community Health Service Center, No. 8, Nongxin Road, Huadu District, Guangzhou City, Guangdong Province, People's Republic of China.
J Orthop Surg Res. 2020 Feb 27;15(1):83. doi: 10.1186/s13018-020-01608-7.
Retrospective cohort study.
To evaluate the effect of time to first ambulation on recurrence after percutaneous endoscopic lumbar discectomy (PELD).
From July 2017 to August 2018, 90 patients with lumbar intervertebral disc herniation underwent PELD surgery. According to the initial walking time, i.e., the time until the patient could walk after the operation, the operations were divided into three groups: early stage, middle stage, and late stage. The follow-up period was 3 months, and complete follow-up data were obtained. The visual analog scale (VAS) and Oswestry disability index (ODI) scores before the operation, at first ambulation, 1 month after the operation, and 3 months after the operation and the recurrence and incidence rates of high magnetic resonance imaging (MRI) signal in the vertebral endplate area were recorded after the operation.
The success rate was 100% for these 90 cases. The VAS and ODI scores at the first ambulation after the operation significantly improved compared with those before the operation, and the difference was statistically significant. The improvements in the lumbar VAS and ODI scores of the middle- and late-stage groups were better than that of the early-stage group at 1 and 3 months after the operation, and the differences were statistically significant; however, there was no significant difference between the middle- and late-stage groups. The postoperative recurrence rate and rate of high MRI signal in the vertebral endplate area were significantly higher in the early-stage group than in the other two groups, and the difference was statistically significant.
The time to first ambulation after PELD is an important factor affecting the curative effect of the operation. Early ambulation may be one of the factors affecting recurrence after PELD.
回顾性队列研究。
评估经皮内镜腰椎间盘切除术（PELD）后首次下床活动时间对复发的影响。
2017 年 7 月至 2018 年 8 月，90 例腰椎间盘突出症患者行 PELD 手术。根据初次下床活动时间，即术后患者可行走的时间，将手术分为早期、中期和晚期三组。随访时间为 3 个月，获得完整随访资料。记录术前、初次下床活动时、术后 1 个月及 3 个月的视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）评分，以及术后椎体终板区高磁共振成像（MRI）信号的复发率和发生率。
90 例患者均手术成功。术后初次下床活动时 VAS 和 ODI 评分较术前明显改善，差异有统计学意义。术后 1、3 个月，中晚期组的腰椎 VAS 和 ODI 评分改善均优于早期组，差异有统计学意义；但中晚期组间差异无统计学意义。早期组术后复发率及椎体终板区高 MRI 信号发生率明显高于其他两组，差异有统计学意义。
PELD 术后首次下床活动时间是影响手术疗效的重要因素。早期下床活动可能是影响 PELD 术后复发的因素之一。
