Efficacy Analysis of Percutaneous Endoscopic Lumbar Discectomy Combined with PEEK Rods for Giant Lumbar Disc Herniation: A Randomized Controlled Study

Abstract

Objective. This study describes a randomized controlled trial that assesses percutaneous endoscopic lumbar discectomy (PELD) combined with a polyetheretherketone (PEEK) rod in patients with GLDH (herniation affecting 50% of the sagittal diameter of the spinal canal) and reports the 2-year follow-up outcome. Methods. In all, 243 patients were randomly assigned to undergo PELD or PELD combined with a PEEK rod by generating random numbers with a random number generator. Clinical outcome data, including the numerical rating scale (NRS), were used to assess the patients’ back and leg pain, while the Oswestry Disability Index (ODI) was used to quantify pain and disability. Imaging data included intervertebral disc height (IDH), range of motion (ROM), and modified Pfirrmann grades. Results. At the final follow-up, the NRS for back and leg pain and the ODI scores were significantly decreased in both groups. The NRS for back pain and the ODI scores in the PELD + PEEK group (1.32 ± 0.70, 14.10 ± 4.74) were better than those in the PELD group (1.91 ± 0.69, 16.93 ± 4.33) (P<0.05). The IDH of the PELD + PEEK group (10.54 ± 1.62) was significantly higher than that in the PELD group (9.98 ± 1.90) (P=0.025). The ROM of the PELD + PEEK group (2.39 ± 0.90) was significantly lower than that of the PELD group (9.49 ± 1.62) (P<0.001). Conclusion. For symptomatic patients with GLDH, both PELD and PELD combined with a PEEK rod showed good efficacy. However, the long-term effect of PELD combined with a PEEK rod is better than that of PELD alone. Moreover, PELD combined with a PEEK rod can effectively reduce the recurrence rate. Maximum benefit can be gained if we adhere to strict selection criteria for PELD combined with a PEEK rod.

Effects of Enhanced Recovery Rehabilitation Surgery Concepts on the Surgical Process, Postoperative Pain, Complications, and Prognosis of Discectomy in Patients with Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

“…Full text of the remaining 52 articles was carefully evaluated. 9 studies that met the inclusion and exclusion criteria were eventually included in this meta-analysis [22][23][24][25][26][27][28][29][30]. A total of 2505 patients were included in this analysis, and the basic characteristics of the included study are shown in Table 1.…”

Full Endoscopy Combined with Allogeneic Bone Grafting for Benign Spinal Lesions: Technical Notes and Preliminary Clinical Results

“…Our research team has extensive experience in endoscopic procedures using full spinal endoscopy for degenerative spinal diseases [19][20][21][22][23]. We were aware of the various advantages of endoscopy, such as visualization of the operation, minimal surgical trauma, and rapid recovery, so we began to apply our endoscopic technique to benign spinal lesions.…”

Comparison of Percutaneous Endoscopic Interlaminar Discectomy and Open Fenestration Discectomy for Single-Segment Huge Lumbar Disc Herniation: A Two-year Follow-up Retrospective Study

“… 2 According to statistics, the incidence of huge lumbar disc herniation (HLDH) accounts for 8 to 22% of all cases of LDH. 3 As a special type of lumbar disc herniation, HLDH usually results in more severe back and leg pain, as well as often associated with neurological deficits, compared to general LDH. 4 , 5 The long-term clinical outcomes of Spine Patient Outcomes Research Trial (SPORT) suggested significantly greater improvement in pain, function and satisfaction in operative group compared to nonoperative group.…”