The Analysis Of Curative Effect On Percutaneous Endoscopic Lumbar Discectomy In The Treatment Of Lumbar Disc Herniation In Adolescents

Objective: To explore the advantages of Percutaneous Endoscopic Lumbar Discectomy in the treatment of lumbar disc herniation in adolescents.Methods: A total of 19 adolescent patients with lumbar disc herniation who underwent Percutaneous Endoscopic Lumbar Discectomy (PELD) were selected from the Department of Spine Surgery in The Affiliated Yan'an Hospital of Kunming Medical University from September 2013 to March 2016. The data collected from patients included operation time, length of surgical incision, intraoperative blood loss and hospitalization. The use of low back pain and lower extremity pain overall VAS score and the JOA score were obtained before surgery, 7 days after surgery, 3 months after surgery and 12 months after surgery, then compared with before and after treatment differences in efficacy. And the clinical efficacy was evaluated on the basis of Macnab score of 12 months postoperatively.Results: We found that all 19 cases of surgery were successfully completed, did not produce postoperative complications. The average operation time was 54.3 minutes,the average length of the surgical incision was 0.7cm, the average intraoperative blood loss was 8ml,and the hospitalization time was 4 ?10 days. All patients were followed up for 3 months and 12 months after surgery. Surgical-related complications were not found during follow-up. The low back pain and lower extremity pain overall VAS score before surgery was (7.00 ±0.86),7 days after surgery was (2.05 ± 0.69),3 months after surgery was (1.11 ± 0.64),12 months after surgery was (0.63 ±0.58).Compared with preoperative, the difference was statistically significant (P<0.05). The JOA score before surgery was (9.37±0.98), 7 days after surgery was(16.58±1.39),3 months after surgery was (22.95± 1.05),12 months after surgery was(26.74±0.85).Compared with preoperative, the difference was statistically significant(P <0.05). The improvement rate(%) of JOA score at 7 days after surgery was(37.18±7.23), and all 19 cases, were effective. The improvement rate(%) at 3 months after surgery was (69.12±5.39), and 18 cases were markedly effective, 1 case was effective. The improvement rate(%) at 12 months after surgery was (88.42±4.49), and all 19 cases were markedly effective. According to the Macnab score of 12 months after surgery of clinical efficacy, in all 19 cases, 11 cases were excellent (57.9%), 8 cases were good (42.1%), the excellent and good rate was 100%.Conclusions:1. Percutaneous Endoscopic Lumbar Discectomy (PELD) is a safe and effective way to treat Lumbar Disc Herniation (LDH) in adolescents.2. The PELD treatment long-term efficacy and the recurrence rate and the impact on the growth and development of LDH in adolescents still need more clinical observation and more in-depth study.