Posterior Percutaneous Endoscopic Lumbar Discectomy Combined With The Vertical Anchoring Technique For Lumbar Disc Herniation With Distant Upward Migration

Objective: To investigate the feasibility,safety,clinical efficacy and technical points of posterior percutaneous endoscopic lumbar discectomy(PELD)combined with the vertical anchoring technique(VAT)for the treatment of lumbar disc herniation(LDH)with distant upward migration.Methods: Thirteen patients with distant upward migrated LDH who underwent posterior PELD combined with the VAT from March 2016 to May 2018 were selected.Among these cases,The herniated disc was located at L3/4 in 2 patients,L4/5 in 9 patients and L5/S1 in 2 patients.The operative time,length of hospital stay and postoperative complications were recorded.The visual analogue score(VAS),Oswestry Disability Index(ODI),Japanese Orthopaedic Association(JOA)scores and modified MacNab criteria were used to assess surgical efficacy.Results: All 13 patients underwent successful surgery.We compared the VAS,ODI and JOA scores before and after surgery.The differences were statistically significant(P<0.05).According to the modified MacNab criteria,10 patients were assessed as “excellent”,2 patients were assessed as “good”,and one patient was assessed as “fair” at the last follow-up.The rate of satisfactory outcomes was 92.3%.Conclusion: Posterior PELD combined with the VAT is a safe and feasible procedure for the treatment of LDH with distant upward migration and represents a new approach for this type of surgery.