Department of Orthopedics, Tokushima University, Tokushima.
Department of Orthopedics, Sendai Nishitaga Hospital, Sendai.
J Pediatr Orthop B. 2020 Nov;29(6):599-606. doi: 10.1097/BPB.0000000000000726.
There are no reports in the literature on the clinical outcomes of percutaneous endoscopic lumbar discectomy (PELD) for high school athletes suffering from herniated nucleus pulposus (HNP) of the lumbar spine. PELD is a minimally invasive surgical procedure that can be performed under local anesthesia via an 8-mm skin incision. This study examined the outcomes of transforaminal PELD in high school athletes suffering from HNP. Subjects were 18 patients [14 males and four females; mean age 17 (15-18) years] who underwent PELD at our institutions. The events in which the patients competed were baseball (n = 6), softball (n = 2), rugby (n = 2), basketball (n = 2), table tennis (n = 2), American football (n = 1), wrestling (n = 1), track and field (n = 1), and dance (n = 1). All patients underwent PELD under local anesthesia. Back pain was assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and a visual analog scale (VAS) before and after surgery. Time to return to competitive sport, complications, and rate of recurrence of herniation were examined. All factors assessed by the JOABPEQ were significantly improved after surgery. VAS score was also improved after surgery. Time to return to competitive sport was 7 weeks on average. The rate of return to play was 94.4%. There were no complications, such as dural tear, exiting nerve root injury, or hematoma. One patient had recurrence of HNP. PELD is a promising minimally invasive and effective procedure for high school athletes with HNP.
目前,尚无文献报道青少年腰椎间盘突出症(HNP)患者行经皮内窥镜下腰椎间盘切除术(PELD)的临床结果。PELD 是一种微创外科手术,可以在局部麻醉下通过 8mm 的皮肤切口进行。本研究探讨了经皮椎间孔内窥镜下腰椎间盘切除术(PELD)治疗青少年 HNP 的效果。研究对象为 18 例在我院接受 PELD 治疗的患者[14 名男性,4 名女性;平均年龄 17 岁(15-18 岁)]。患者参加的运动项目有棒球(n=6)、垒球(n=2)、橄榄球(n=2)、篮球(n=2)、乒乓球(n=2)、美式足球(n=1)、摔跤(n=1)、田径(n=1)和舞蹈(n=1)。所有患者均在局部麻醉下接受 PELD。手术前后采用日本矫形协会腰痛评估问卷(JOABPEQ)和视觉模拟评分(VAS)评估腰痛。评估术后重返竞技运动的时间、并发症和复发率。JOABPEQ 评估的所有因素在手术后均显著改善,VAS 评分也有所改善。平均术后 7 周可重返竞技运动,患者的回归率为 94.4%。无并发症发生,如硬脊膜撕裂、神经根出口损伤或血肿。1 例患者出现 HNP 复发。PELD 是治疗青少年 HNP 的一种有前途的微创、有效的方法。