School of Medicine, Southeast University, Nanjing, China.
The Department of Orthopedics, Zhongda Hospital of Southeast University, Nanjing, China.
Biomed Res Int. 2021 Jul 12;2021:9911579. doi: 10.1155/2021/9911579. eCollection 2021.
To investigate whether lumbosacral transitional vertebrae (LSTV) affects the clinical outcomes of percutaneous endoscopic lumbar discectomy (PELD) in adolescent patients with lumbar disc herniation (LDH).
This was a retrospective study with two groups. Group A was made up of 22 adolescent LDH patients with LSTV (18 males and 4 females). Group B was made up of 44 adolescent LDH patients without LSTV (36 males and 4 females), who were matched to group A for age, sex, and body mass index. All patients underwent PELD at the L4/5 or L5/S1 single level and were followed up at 18 months after surgery. We identified LSTV on radiographs and computed tomography and assessed the imaging characteristics of all patients. Outcomes were evaluated through a numerical rating scale (NRS), the Oswestry Disability Index (ODI), the modified MacNab grading system, and the incidence of additional lumbar surgery.
At 18 months after PELD, both groups had significant improvements in the mean NRS scores of low back pain (LBP) or leg pain and the ODI scores. In terms of the MacNab criteria, 90.9% in group A and 93.2% in group B showed excellent or good outcomes. The mean NRS scores of LBP or leg pain, ODI score, and MacNab grade after surgery were not significantly different between the 2 groups. Two patients (one patient had a recurrence; one patient had a new lumbar disc herniation) in group A and 3 patients (one patient had a recurrence; two patients had new lumbar disc herniations) in group B underwent additional lumbar surgery.
Our study suggests that in terms of pain relief, life function improvement, and the incidence of additional lumbar surgery, LSTV has no effect on the short-term clinical outcomes of PELD in adolescents. A new lumbar disc herniation is an important reason for additional surgery in adolescents, regardless of the LSTV status.
探讨腰骶移行椎（LSTV）是否影响青少年腰椎间盘突出症（LDH）患者经皮内镜腰椎间盘切除术（PELD）的临床疗效。
这是一项回顾性研究，分为两组。A 组为 22 例伴有 LSTV 的青少年 LDH 患者（男 18 例，女 4 例），B 组为 44 例不伴有 LSTV 的青少年 LDH 患者（男 36 例，女 4 例），两组患者在年龄、性别和体重指数方面相匹配。所有患者均在 L4/5 或 L5/S1 单节段行 PELD，并在术后 18 个月进行随访。我们在影像学上确定 LSTV，并评估所有患者的影像学特征。通过数字评分量表（NRS）、Oswestry 功能障碍指数（ODI）、改良 MacNab 分级系统以及附加腰椎手术的发生率来评估结果。
在 PELD 术后 18 个月时，两组患者的腰痛（LBP）或腿痛 NRS 评分和 ODI 评分均有显著改善。根据 MacNab 标准，A 组有 90.9%、B 组有 93.2%的患者疗效为优或良。两组患者术后的 LBP 或腿痛 NRS 评分、ODI 评分和 MacNab 分级无显著差异。A 组中有 2 例（1 例复发，1 例新发腰椎间盘突出症）、B 组中有 3 例（1 例复发，2 例新发腰椎间盘突出症）患者行附加腰椎手术。
本研究表明，在缓解疼痛、改善生活功能和附加腰椎手术发生率方面，LSTV 对青少年 PELD 的短期临床疗效无影响。新发腰椎间盘突出症是青少年行附加手术的重要原因，与 LSTV 状态无关。
