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| Clinical outcomes of patients with lumbar disc herniation with lateral recess stenosis treated by percutaneous transforaminal endoscopic lumbar discectomy |
| YANG Gang TIAN Yafeng YU Jian ZHU Yanfeng HAN Kun DONG Junge |
| The First Department of Osteology, Hebei Provincial Traditional Chinese Meditional Hospital, Hebei Province, Shijiazhuang 050017, China |
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Abstract Objective To evaluate the outcome and safety of percutaneous endoscopic lumbar discectomy (PELD) for lumbar disc herniation with lateral recess stenosis. Method A total of 85 patients with lumbar disc herniation admitted to the First Department of Osteology, Hebei Hospital of Traditional Chinese Medicine from August 2014 to August 2019 were selected as the study subjects. All patients received PELD, and 70 patients were followed up for two years. Postoperative MRI or CT examination was performed. Clinical outcomes were evaluated using the visual analog scale (VAS) score, Oswestry disability index (ODI), and modified MacNab criteria at three, six month, one, and two year after surgery. Results 70 patients were followed up for two years, including three patients with the L3-4 lumbar segment, 57 patients with the L4-5 lumbar segment, 10 patients with the L5-S1 lumbar segment, 31 males and 39 females. The age range was 44 to 75 years old, with a mean of (54.2±7.7) years old. All patients underwent PELD for nucleus pulposus removal and lateral recess enlargement decompression. Three patients with transient postoperative sensory disturbance were L5-S1 segment patients, and postoperative MRI/CT examination showed sufficient decompression. None of the patients developed postoperative infection, dysfunction, nerve root injury, or iatrogenic segmental instability. The VAS scores and ODI values of the 70 patients were lower than those before surgery at all follow-up time points, and the differences were statistically significant (P＜0.05). MacNab score two years after surgery, 24 cases were excellent, 39 cases were good, 6 cases were fair, and 1 case was poor. The rate of excellent and good was 90.0%. Conclusion PELD is a less invasive, effective and safe surgery for lumbar disc herniation with lateral recess stenosis.
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