Comparison of the efficacy of arthroscopic-assisted uni-portal spinal surgery and percutaneous endoscopic lumbar discectomy in the treatment of far lateral lumbar disc herniation: a retrospective controlled study.
Jianmin Li, Zhichao Ge, Dong Zhang, Kai Lv, Hao Sun, Jiajun Wu, En Song, Tao Li, Shuqiang Wang
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引用次数: 0
Abstract
Purpose: To analyze the clinical efficacy of arthroscopic-assisted uni-portal spinal surgery (AUSS) in the treatment of far lateral lumbar disc herniation (FLLDH).
Methods: A retrospective analysis was conducted on 120 cases of FLLDH patients. The patients were divided into two groups based on the treatment methods: the control group (CG, n = 68) underwent percutaneous endoscopic lumbar discectomy (PELD), while the study group (SG, n = 52) received nucleus pulposus removal under the AUSS technique. Perioperative indicators, 6-month postoperative efficacy rate, and postoperative complications were collected and compared between the two groups. Additionally, preoperative and postoperative patient assessments included pain levels [Visual Analogue Scale (VAS)], Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score and lumbar mobility.
Results: Compared to the CG, the SG demonstrated a shorter operative time, as well as reduced time to ambulation and postoperative hospital stay (P < 0.05), while there was no statistically significant difference in intraoperative blood loss between the two groups (P > 0.05). The overall efficacy rate at 6 months postoperatively in the SG (94.23%) was higher than that in the CG (79.41%) (P < 0.05). The incidence of postoperative complications in the SG (5.77%) was lower than that in the CG (19.12%) (P < 0.05). At 3 and 6 months postoperatively, the SG showed lower VAS and ODI scores and higher JOA scores than the CG (P < 0.05). The ranges of motion for left lateral bending, flexion, extension, and right lateral bending of the SG were greater than those of the CG at 3 and 6 months postoperatively (P < 0.05).
Conclusion: The AUSS technique demonstrates superior efficacy over PELD in the treatment of FLLDH, effectively alleviating pain, enhancing functional outcomes, and improving quality of life, with a lower incidence of complications. Its minimally invasive nature and remarkable recovery efficiency highlight its promising clinical potential, warranting further validation of long-term outcomes through prospective follow-up studies.
目的：分析关节镜辅助下单门静脉脊柱手术（AUSS）治疗远外侧腰椎间盘突出症的临床疗效。方法：对120例FLLDH患者进行回顾性分析。根据治疗方法将患者分为两组：对照组（CG, n = 68）行经皮内镜下腰椎间盘切除术（PELD），研究组（SG, n = 52）行AUSS技术下髓核切除。收集两组围手术期指标、术后6个月有效率及术后并发症进行比较。此外，术前和术后患者评估包括疼痛水平[视觉模拟量表（VAS）]、Oswestry残疾指数（ODI）、日本骨科协会（JOA）评分和腰椎活动度。结果：与CG相比，SG的手术时间、活动时间和术后住院时间均缩短（P < 0.05）。SG组术后6个月总有效率（94.23%）高于CG组（79.41%）。(P)结论：AUSS技术治疗FLLDH的疗效优于PELD，可有效减轻疼痛，改善功能结局，改善生活质量，并发症发生率低。其微创性和显著的恢复效率突出了其良好的临床潜力，需要通过前瞻性随访研究进一步验证其长期疗效。
期刊介绍：
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe
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