Percutaneous Endoscopic Lumbar Discectomy Combined With PEEK Rods Dynamic Fixation For Treatment Of Large Lumbar Disc Herniation

Objective: to evaluate the clinical and radiographic outcomes of PELD(percutaneous endoscopic lumbar discectomy)combined with PEEK(polyetheretherketone)rods dynamic fixation for treatment of LLDH(Large lumbar Disc Herniation).Methods: 52 patients with large lumbar disc herniation treated by PELD combined with PEEK rods dynamic fixation were included,and the NRS,ODI scores and imaging data(IDH,ROM,and modified Pfrimann grade of intervertebral disc)were collected.Results: the NRS and ODI scores of all postoperative follow-up time points were lower than those before the operation(P < 0.05),the fixed segment’s IDH of 1 day after the operation was higher than that before the operation(P < 0.005),and the fixed segment’s IDH of 1 year and final follow-up after the operation was lower than that before the operation(P <0.005).Cranial segment’s ROM was higher than preoperative ROM(P <0.005)at 3 months,1 year after the surgery and the last follow-up time,while fixed segment’s ROM after surgery was lower than preoperative ROM(P < 0.005).The Pfirrmann grading of the caudal segment and the fixed segment after the operation was significantly different than that before the operation(p < 0.05).Conclusion: PELD combined with PEEK rods dynamic fixation achieved significant improvement in clinical outcomes in short and mid-term follow-up.It can stabilize the spine and at the same time reserve some ROM.Also it can maintain IDH early in the postoperative period,reduce the risk of postoperative recurrence,may delay the degeneration of Superior adjacent segment,and may accelerate self-repair of disc tissue.