Department of Orthopaedics, China-Japan Union Hospital of Jilin University, 130033, Jilin, China.
Department of Orthopaedics, Beijing Tongren Hospital Affiliated to Capital Medical University, 100730, Beijing, China.
BMC Musculoskelet Disord. 2022 Mar 12;23(1):244. doi: 10.1186/s12891-022-05186-z.
Percutaneous endoscopic lumbar discectomy (PELD) is a relatively safe and effective minimally invasive surgery in the treatment of calcified lumbar disc herniation (CLDH). However, studies on percutaneous endoscopic interlaminar discectomy (PEID) and percutaneous endoscopic transforaminal discectomy (PETD) for CLDH have rarely been reported. This research aimed to compare the clinical efficacy of PEID and PETD for L5-S1 CLDH.
We retrospectively analyzed 54 consecutive patients with L5-S1 CLDH treated with PELD at our institution from August 2016 to August 2020. Patients were divided into PEID group (n = 28) and PETD (n = 26) group according to the surgical methods. The demographic characteristics and surgical results of the two groups were compared. Clinical outcomes were estimated by the visual analog scale (VAS) for leg pain, Oswestry disability index (ODI) and modified MacNab criteria.
All patients were successfully operated on by PEID or PETD. No significant differences in the demographic characteristics, intraoperative blood loss, postoperative hospital stay and complication rate were noted between the PEID and PETD groups. The excellent and good rates in the PEID group were similar to those in the PETD group (89.29% vs 88.46%, P = 1.000), whereas the PEID group exhibited superior results for operative time (min) (64.61 ± 5.60 vs 85.58 ± 8.52, P < 0.001) and fluoroscopy times (n) (2.93 ± 0.90 vs 13.35 ± 2.30, P < 0.001) compared with the PETD group.
PEID has achieved good clinical efficacy as PETD for L5-S1 CLDH. Compared with PETD, PEID has the advantages of shorter operative time and a reduced number of fluoroscopy times in the treatment of CLDH.
经皮内镜腰椎间盘切除术（PELD）是治疗钙化型腰椎间盘突出症（CLDH）的一种相对安全且有效的微创手术。然而，关于经皮内镜椎间孔入路椎间盘切除术（PEID）和经皮内镜经椎间孔入路椎间盘切除术（PETD）治疗 CLDH 的研究很少有报道。本研究旨在比较 PEID 和 PETD 治疗 L5-S1 CLDH 的临床疗效。
我们回顾性分析了 2016 年 8 月至 2020 年 8 月在我院接受 PELD 治疗的 54 例 L5-S1 CLDH 患者。根据手术方法将患者分为 PEID 组（n=28）和 PETD 组（n=26）。比较两组患者的一般资料和手术结果。采用视觉模拟评分（VAS）评估腿痛、Oswestry 功能障碍指数（ODI）和改良 MacNab 标准评估临床疗效。
所有患者均成功接受 PEID 或 PETD 手术。两组患者在一般资料、术中出血量、术后住院时间和并发症发生率方面差异均无统计学意义。PEID 组的优良率与 PETD 组相似（89.29%比 88.46%，P=1.000），但手术时间（min）（64.61±5.60 比 85.58±8.52，P<0.001）和透视次数（n）（2.93±0.90 比 13.35±2.30，P<0.001）均明显短于 PETD 组。
PEID 治疗 L5-S1 CLDH 的临床疗效与 PETD 相当。与 PETD 相比，PEID 治疗 CLDH 具有手术时间更短、透视次数更少的优点。
