Efficacy Analysis Of Percutaneous Endoscopic Lumbar Discectomy Combined With PEEK Rods For Giant Lumbar Disc Herniation: A Randomized Controlled Study

Objective: This study describes a randomized controlled trial that assesses percutaneous endoscopic lumbar discectomy(PELD)combined with a polyetheretherketone(PEEK)rod in patients with GLDH(herniation affecting 50% of the sagittal diameter of the spinal canal)and reports the 2-year follow-up outcome.Methods: In all,243 patients were randomly assigned to undergo PELD or PELD combined with a PEEK rod by generating random numbers with Random Number Generator.Clinical outcome data,including the numerical rating scale(NRS)was used to assess the patients’ back and leg pain,while the Oswestry disability index(ODI)was used to quantify pain and disability.Imaging data included intervertebral disc height(IDH),range of motion(ROM)and modified Pfirrmann grades.Results: At the final follow-up,the NRS for back and leg pain as well as the ODI scores were significantly decreased in both groups.The NRS for back pain and the ODI scores in the PEEK+PELD group were better than those in the PELD group(P<0.05).The IDH of the PEEK+PELD group was significantly higher than that in the PELD group(P<0.05).The ROM of the PEEK+PELD group was significantly lower than that of the PELD group(P<0.05).The modified Pfirrmann grades of surgical segment in PEEK+PELD group were lower than that of the PELD group(P<0.05).The modified Pfirrmann grades of adjacent segments in both group showed no statistical difference.Conclusion: For symptomatic patients with GLDH,both PELD and PELD combined with a PEEK rod showed good efficacy.However,the long-term effect of PELD combined with a PEEK rod is better than that of PELD alone.Moreover,PELD combined with a PEEK rod can effectively reduce the recurrence rate,and didn’t increase the risk of ASD.