Department of Minimally Invasive Spine Surgery, Shandong Wendeng Orthopedic Hospital, Weihai, Shandong, P.R. China.
Department of Neurology, Weihai Central Hospital, Weihai, Shandong, P.R. China.
Medicine (Baltimore). 2024 Oct 25;103(43):e40298. doi: 10.1097/MD.0000000000040298.
This retrospective study aimed to investigate the clinical efficacy of single-channel percutaneous endoscopic nucleotomy combined with annulus fibrosus suturing for treating lumbar disc herniation (LDH). The study included 86 patients with LDH treated in our spinal department from August 2020 to January 2022. The suture group consisted of 26 males and 18 females, while the control group (nucleotomy alone) included 25 males and 17 females. All patients were followed for at least 1 year, with follow-up points at 3 days, 3 months, and 12 months postoperatively. Various clinical and radiological indicators were used to evaluate and compare the efficacy and safety of the 2 procedures. No statistically significant differences were observed in age, sex, BMI, surgical segments, degree of disc degeneration, or postoperative length of hospital stay. However, the suture group had a longer operative time (63.28 ± 4.17 minutes vs 54.71 ± 4.89 minutes, t = 8.759, P < .05). At 12 months postoperatively, neither group showed aggravated disc degeneration. There was also no significant difference in excellent rates between the 2 groups (95.45% vs 92.86%, X2=0.265, P = .607). However, the suture group had a lower intervertebral disc height loss rate compared to the control group (22.3% ± 4.6% vs 29.8% ± 6.2%, X2=6.390, P < .001). In conclusion, single-channel percutaneous endoscopic nucleotomy combined with annulus fibrosus suturing is a safe and reliable treatment for LDH. It effectively reduces the recurrence rate, slows disc degeneration and loss of disc height, and achieves excellent early outcomes.
本回顾性研究旨在探讨单通道经皮内窥镜下髓核切除术联合纤维环缝合治疗腰椎间盘突出症(LDH)的临床疗效。研究纳入 2020 年 8 月至 2022 年 1 月在我院脊柱科治疗的 86 例 LDH 患者。缝合组 26 例,男 18 例,对照组(单纯髓核切除术)25 例,男 17 例。所有患者均至少随访 1 年,随访点为术后 3 天、3 个月和 12 个月。采用多种临床和影像学指标评估和比较两种手术的疗效和安全性。两组患者在年龄、性别、BMI、手术节段、椎间盘退变程度或术后住院时间方面无统计学差异。然而,缝合组的手术时间较长(63.28±4.17 分钟比 54.71±4.89 分钟,t=8.759,P<.05)。术后 12 个月,两组患者椎间盘均无明显退变加重。两组优良率无统计学差异(95.45%比 92.86%,X2=0.265,P=0.607)。然而,缝合组椎间盘高度丢失率低于对照组(22.3%±4.6%比 29.8%±6.2%,X2=6.390,P<.001)。综上所述,单通道经皮内窥镜下髓核切除术联合纤维环缝合治疗 LDH 安全可靠,可有效降低复发率,减缓椎间盘退变和高度丢失,获得良好的早期疗效。