Abstract：Objective To study the anatomic advantages and clinical outcomes of percutaneous endoscopic lumbar discectomy(PELD) in the reoperation treatment of lumbar disc reherniation.Methods Using the prospective randomized study method, 25 continuous patients (Department of Orthopaedics, the No.113 Hospital of PLA) suffered with lumbar disc reherniation from May 2011 to Apr 2014 were enrolled in our study, and randomly divided into percutaneous endoscopic lumbar discectomy group (PELD group, 13 cases) and posterior lumbar interbody fusion(PLIF) group (PLIF group, 12 cases) according to odd or even of the mantissa number of the patients′ hospital ID. We observed the differences in operative time, blood loss, complications, and clinical efficacy between the two groups.Results The operation time of PLED group [(2.3±1.1)h] was longer than the PLIF group [(1.9±0.8)h], but the blood loss of PLED group [(40±15)mL] was obviously less than that of PLIF group [(340±150)mL](all P values<0.05). After a mean follow-up of 20 months, the outcome of surgical treatment showed excellent in 11 cases and good in 2 cases in PLED group, and excellent in 9 cases, good in 2 cases and fair in 1 case in PLIF group. There was no statistically significant difference in VAS and ODI scores between the PLED and PLIF group before surgery, and at the 3 months and 1 year follow-up postoperatively (all P values>0.05). The ODI and VAS score were obviausly lower than before surgery at the 3 months and 1 year follow-up postoperatively in the two groups(all P values＜0.01), respectively.Conclusions Percutaneous endoscopic lumbar discectomy was performed through the lateral approach, which was different from the back anatomic approach in the primary surgery. PLED could easily remove the herniated nucleus in the ventral of the nerve roots without retract the dural sac and nerve roots. Percutaneous endoscopic lumbar discectomy has many advantages such as small injury, less bleeding, shorter hospitalization period, faster postoperative recovery, less damage of the lumbar biomechanics, and so on. It can be effectively used in the treatment of lumbar disc reherniation.
李纯志, 刘伟, 赵宏, 方煜. 椎间孔镜微创髓核摘除术用于腰椎间盘突出症再手术的解剖学优势[J]. 中华解剖与临床杂志, 2016, 21(2): 137-141.
Li Chunzhi, Liu Wei, Zhao Hong, Fang Yu.. Anatomic advantage of percutaneous endoscopic lumbar discectomy in the reoperation treatment of lumbar disc reherniation. Chinese Journal of Anatomy and Clinics, 2016, 21(2): 137-141.
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2016, Vol. 21 
