Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Orthopaedics, China-Japan Friendship Hospital, Beijing, China.
J Orthop Surg Res. 2024 Jun 8;19(1):341. doi: 10.1186/s13018-024-04831-8.
Percutaneous endoscopic lumbar discectomy (PELD) has demonstrated efficacy in alleviating leg pain among patients with lumbar disc herniation. Nonetheless, residual back pain persists as a troubling issue for surgeons following the procedure. In the treatment of discogenic back pain, sinuvertebral nerve radiofrequency ablation has shown promising results. Nevertheless, the potential benefit of simultaneously implementing sinuvertebral nerve radiofrequency ablation during PELD surgery to address residual back pain has not been thoroughly investigated in current literature.
This retrospective study reviewed Lumbar disc herniation (LDH) patients with low back pain who underwent combined PELD and sinuvertebral nerve ablation in our department between January 2021 and September 2023. Residual low back pain post-surgery was assessed and compared with existing literature.
A total of 80 patients, including 53 males and 27 females, were included in the study. Following surgical intervention, patients demonstrated remarkable improvements in pain and functional parameters. One month post-operatively, the VAS score for low back pain exhibited a 75% reduction (6.45 ± 1.3 to 1.61 ± 1.67), while the VAS score for leg pain decreased by 85% (7.89 ± 1.15 to 1.18 ± 1.26). Notably, the JOA score increased from 12.89 ± 5.48 to 25.35 ± 4.96, and the ODI score decreased form 59.48 ± 9.58 to 20.3 ± 5.37. These improvements were sustained at three months post-operatively. According to the modified Mac Nab criteria, the excellent and good rate was 88.75%. Residual low back pain is observed to be comparatively reduced compared to the findings documented in earlier literature.
The combination of percutaneous endoscopic lumbar discectomy and sinuvertebral nerve ablation demonstrates effective improvement in low back pain for LDH patients.
经皮内镜腰椎间盘切除术（PELD）已被证明能有效缓解腰椎间盘突出症患者的下肢疼痛。然而，手术后残留腰痛仍然是外科医生面临的一个问题。在治疗椎间盘源性腰痛方面，经椎间孔脊神经射频消融术已显示出良好的效果。然而，在当前文献中，尚未充分研究在 PELD 手术中同时进行脊神经射频消融术以解决残留腰痛的潜在益处。
本回顾性研究纳入了 2021 年 1 月至 2023 年 9 月期间在我科行 PELD 联合脊神经消融术的腰椎间盘突出症（LDH）患者。评估并比较了术后残留腰痛。
共有 80 例患者（53 例男性，27 例女性）纳入本研究。术后患者疼痛和功能参数均显著改善。术后 1 个月，腰痛 VAS 评分降低 75%（6.45±1.3 至 1.61±1.67），腿痛 VAS 评分降低 85%（7.89±1.15 至 1.18±1.26）。值得注意的是，JOA 评分从 12.89±5.48 增加到 25.35±4.96，ODI 评分从 59.48±9.58 降低到 20.3±5.37。这些改善在术后 3 个月时仍持续存在。根据改良 Mac Nab 标准，优良率为 88.75%。与早期文献记录的结果相比，残留腰痛明显减轻。
经皮内镜腰椎间盘切除术联合脊神经射频消融术可有效改善腰椎间盘突出症患者的腰痛。
