A Preliminary Clinical Study Of Percutaneous Endoscopic Lumbar Discectomy Combined With Non-fusion Internal Fixation For Huge Lumbar Disc Herniation

Objective:To evaluate the safety,feasibility and clinical efficacy of percutaneous endoscopic lumbar discectomy combined with PEEK semi-rigid rod non-fusion fixation via minimally invasive channel for huge lumbar disc herniation.Methods:From June 2014 to October 2015,21 patients were treated with percutaneous endoscopic lumbar discectomy combined with PEEK semi-rigid rod non-fusion fixation via minimally invasive channel.Visual analogue scale(VAS)scores(back,leg)were recorded before operation and at 1 days,1,3,6 months,the latest follow-up after operation.Oswestry Disability Index(ODI)were recorded before operation and at the latest follow-up after operation.The latest follow-up modified Mac Nab scale were recorded.All the data were statistically analyzed to evaluate the clinical efficacy.Results : All the patients underwent operation successfully.Follow-up(range,7-22 months,mean 13±4.1 months)was achieved in 21 patients.The mean operation time was(189.8±50.6)min.and the mean blood loss was(102.4±88.7)ml.The mean hospital stay was(9±3.1)d.VAS scores(back)improved significantly at postoperative 3,6months,as well as the latest follow-up compared to the preoperative scores,the difference was statistically significant(P<0.05).VAS scores(leg)improved significantly at postoperative 1 day and 1,3,6months,as well as the latest follow-up compared to the preoperative scores,the difference was statistically significant(P<0.05).There was an increase in VAS scores(back)at postoperative 1 day compared to the preoperative scores,the difference was statistically significant(P<0.05).VAS scores(back)at postoperative 1 months compared to the preoperative scores was not statistically significant(P>0.05).There was an increase in ODI scores at the latest follow-up compared to the preoperative scores,the difference was statistically significant(P<0.05).The latest follow-up modified Mac Nab scale shows that 18 excellent,2 good and 1 fair.No recurrence was found at the last follow-up.Conclusions:According to the preliminary analysis of percutaneous endoscopic lumbar discectomy combined with non-fusion internal fixation for huge lumbar disc herniation,the procedure is safe and feasible and has a satisfactory short-term clinical efficacy.However,due to short follow-up time and the lack of comparison with traditional standard fusion and other surgical methods,the long-term efficacy of this technique requires further study.