He Bo, Dong Minghui, Zhang Quan, Bu Jinhui, Xu Long, Huang Sen, Wang Zhenfei, Bu Xiangbo, Hu Mengzi, Liu Guangpu, Liang Jun, Ma Chao, Liu Guangwang
Xuzhou Clinical School of Xuzhou Medical University, Department of Orthopedic Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu, 221009, China.
XuZhou Clinical School of Xuzhou Medical University, Department of Orthopedic Surgery, XuZhou Central Hospital, XuZhou Central Hospital Affiliated to Medical School of Southeast University, The Xuzhou School of Clinical Medicine of Nanjing Medical University, XuZhou Central Hospital Affiliated to Nanjing University of Chinese Medicine, Xuzhou, Jiangsu, 221009, China.
J Orthop. 2024 Nov 28;65:24-30. doi: 10.1016/j.jor.2024.11.015. eCollection 2025 Jul.
To investigate the clinical feasibility, efficacy and safety of a suture technique combining annulus fibrosus with posterior longitudinal ligament under full endoscopy in patients with lumbar disc herniation.
Retrospective case-control study. A total of 412 patients with lumbar disc herniation treated in our hospital from January 2020 to November 2022 were enrolled and analyzed. There were 208 males and 204 females, aged from 26 to 54 years old(average 39.9 ± 5.1). 208 patients were treated with combining annulus fibrous suture with posterior longitudinal ligament after percutaneous lumbar discectomy(PELD) (observation group)0.204 patients were treated with percutaneous lumbar discectomy(PELD) alone(control group). Operation time, blood loss, Visual Analogue scale(VAS), Oswestry disability index(ODI),Japanese Orthopedic Association(JOA), modified MacNab criteria and imaging examination were used to evaluate.
All the 412 patients successfully completed the surgery. Complete follow-up time was 12-18 months, with an average of 15.2 ± 1.6 months. Postoperative symptoms were all significantly relieved. There was no statistically significant difference in baseline data between groups (P > 0.05). The scores of VAS,ODI and JOA at different postoperative follow-up visits were significantly lower than those before surgery (P < 0.05). There was significant difference in each group before and after surgeries (P < 0.05). The postoperative recurrence rates and reoperation rates between groups were significant different(P < 0.05). According to MacNab, the excellent and good rate was 96.2 % (200/208) in observation group and 90.7 % (185/204) in control group(P < 0.05).
The suture technique combining annulus fibrosus with posterior longitudinal ligament under full endoscopy in patients with lumbar disc herniation has satisfactory short- and mid-term clinical effect,and can effectively reduce postoperative recurrence rate, which is a safe and ideal suture technique for annulus fibrosus rupture.
not applicable.
探讨全内镜下纤维环与后纵韧带联合缝合技术治疗腰椎间盘突出症的临床可行性、有效性及安全性。
回顾性病例对照研究。纳入并分析2020年1月至2022年11月在我院治疗的412例腰椎间盘突出症患者。其中男性208例，女性204例，年龄26～54岁（平均39.9±5.1岁）。208例患者在经皮腰椎间盘切除术（PELD）后行纤维环与后纵韧带联合缝合（观察组），204例患者单纯行PELD（对照组）。采用手术时间、出血量、视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）、日本骨科学会（JOA）评分、改良MacNab标准及影像学检查进行评估。
412例患者均顺利完成手术。完整随访时间为12～18个月，平均15.2±1.6个月。术后症状均明显缓解。两组基线资料比较差异无统计学意义（P＞0.05）。术后不同随访时间的VAS、ODI及JOA评分均显著低于术前（P＜0.05）。两组手术前后比较差异均有统计学意义（P＜0.05）。两组术后复发率及再次手术率比较差异有统计学意义（P＜0.05）。按MacNab标准，观察组优良率为96.2%（200/208），对照组为90.7%（185/204）（P＜0.05）。
全内镜下纤维环与后纵韧带联合缝合技术治疗腰椎间盘突出症具有满意的中短期临床效果，能有效降低术后复发率，是一种安全、理想的纤维环破裂缝合技术。
不适用。
