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DU Wei,DING Yu,CUI Hongpeng.Clinical observation of percutaneous endoscopic lumbar discectomy combined with platelet-rich plasma gel microspheres implantation for the treatment of lumbar disc herniation[J].Chinese Journal of Spine and Spinal Cord,2020,(11):1001-1006. |
Clinical observation of percutaneous endoscopic lumbar discectomy combined with platelet-rich plasma gel microspheres implantation for the treatment of lumbar disc herniation |
Received:April 02, 2020 Revised:July 20, 2020 |
English Keywords:Lumbar disc herniation Percutaneous endoscopic lumbar discectomy Platelet-rich plasma Minimally invasive surgery |
Fund:首都临床诊疗技术研究及示范应用项目(Z191100006619028);解放军总医院第六医学中心创新培育基金资助项目(CXPY201920) |
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English Abstract: |
【Abstract】 Objectives: To analysis the safety and efficacy of percutaneous endoscopic lumbar discectomy(PELD) combined with platelet-rich plasma(PRP) gel microspheres implantation in patients with lumbar disc herniation(LDH). Methods: From February 2017 to February 2018, 40 patients with LDH treated in our department were randomly divided into observation group and control group, with 20 cases in each group. The observation group was treated with PELD combined with PRP gel microspheres implantation. The patients in observation group included 11 males and 9 females, with an average of 47.8±13.5 years old ranging from 19 to 68 years. The average course of disease was 18.4±12.5 months ranging from 3 to 48 months, with L3/4 4 cases, L4/5 9 cases, and L5/S1 7 cases. The patients in the control group were treated with PELD, including 10 males and 10 females with an average age of 45.9±10.5 years ranging from 27 to 62 years. The average course of disease was 21.9±13.4 months ranging from 5 to 54 months, with L3/4 3 cases, L4/5 11 cases, and L5/S1 6 cases. All the patients were evaluated before the treatment, at the 12th month and final follow-up after the treatment by VAS score, JOA score and Oswestry defunction index(ODI). The intervertebral space height was measured on lumbar X-ray, and Pfirrmann classification on MRI was evaluated before treatment and at final follow-up. Results: There was no significant difference in general data between the two groups(P>0.05). All 40 patients were followed up for 22 to 27 months(averaged 24.2±1.9 months), with no serious adverse reaction or complication. For VAS, JOA, ODI scores and Pfirrmann classification, there was no significant difference between the two groups before the treatment(P>0.05). In each group they were significantly improved at the 12th month postoperatively and the final follow-up comparing with that before operation(P<0.05). There was no significant difference between the two groups at the 12th month and the final follow-up(P>0.05). However, the changes of intervertebral space height and Pfirrmann classification of observation group were significantly better than that in control group at final follow-up(P=0.005, P=0.031). Conclusions: PELD combined with PRP is safe and effective in the treatment of LDH. To some extent, it can slow down disc degeneration and promote disc repair. |
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