Clinical observation of the treatment of lumbar disc herniation with fibrous annulus suture under endoscope

English Keywords:Lumbar disc herniation  Endoscopy  Annulus fibrous repair  Minimally invasive

English Abstract:

  【Abstract】 Objectives: To investigate the application and effect of endoscopic discectomy associated with annulus suture repair in patients with single segment of lumbar disc herniation． Methods: A total of 60 patients with lumbar disc herniation treated by foraminal endoscopic surgery in our hospital from January 2018 to December 2019 were analyzed. There were 45 males and 15 females, aged from 18 to 56 years old(average 45±5). 30 patients were treated with conventional nucleus pulposus excision(group A), and 30 patients were treated with fibrous annulus suture under endoscope after nucleus pulposus excision(group B). Visual analogue scale(VAS), Oswestry disability index(ODI) and imaging examination were used to evaluate the postoperative outcomes. Results: All the patients were followed up for 12 to 24 months, with an average of 15 months. Postoperative symptoms were significantly relieved in both groups. The VAS scores of low back and leg pain in both groups at different postoperative time points(right after operation, 3 months, 1 year and the final follow-up) were significantly lower than those before surgery(P<0.05); There was no significant difference between groups(P>0.05). The ODI at different postoperative time points were significantly lower than those before surgery (P<0.05); There was no significant difference between groups(P>0.05). 2 patients (all was in group A) had recurrence 3 months after surgery, 1 patient received re-foraminal endoscopic surgery, and 1 patient received discectomy and interbody fusion. Imaging review of other patients showed no recurrence or segmental instability. Conclusions: Fibroannular suture under foraminal endoscope conforms to the minimally invasive concept and has satisfactory short-term clinical effect, which can close the annulus fibrosus breach immediately, promote the repair of fibroannular, and reduce the postoperative recurrence rate.