Evaluation of full-endoscopic lumbar discectomy in the treatment of obese adolescents with lumbar disc herniation: a retrospective study

Abstract

Background Obese patients are at risk of complications after spinal surgery. Full-endoscopic lumbar discectomy (FELD) has advantages over conventional open surgery in the treatment of obese adult patients with lumbar disc herniation (LDH) because it can decrease perioperative complications and enhance the degree of patient satisfaction. However, no clinical studies have evaluated the efficacy of FELD in obese adolescents with LDH (ALDH). This study aimed to evaluate the efficacy of FELD for the treatment of obese ALDH. Methods We retrospectively collected clinical data from 208 patients with single-segment ALDH who underwent FELD in our hospital between January 2015 and December 2019. According to the WHO classification of obesity, the patients were divided into obese (BMI ≥30 kg/m2) and non-obese (BMI < 30 kg/m2) groups (control group). Based on the preoperative baseline data of the two groups, propensity score matching was performed to select patients from these groups for a comparative study. Perioperative data included operative time, intraoperative blood loss, and length of postoperative hospitalization. The visual analog scale (VAS), Oswestry disability index (ODI), and modified MacNab criteria were recorded as the main indicators of the surgical outcome. Recurrence rate and incidence of complications were recorded as minor indicators. Results Twenty-eight patients and 80 patients were included in the obese and non-obese groups, respectively, after 1:4 propensity score matching. Both groups showed improvements in VAS and ODI scores after surgery and at each follow-up time point (p < 0.05). However, there was no significant statistical difference in the surgical outcomes between the two groups at each follow-up time point (p > 0.05). The differences in operative time, intraoperative blood loss, and length of postoperative hospitalization were not statistically significant between the two groups (p > 0.05). Conclusion FELD is a safe and effective minimally invasive technique for treating obese patients with ALDH. The efficacy of FELD in obese and non-obese patients with ALDH was comparable.

Risk factors for surgical site infection after percutaneous endoscopic lumbar discectomy

“…The surgical procedure included determination of puncture path, sterilisation, puncture, foraminoplasty, placement of the working cannula and decompression of the nerve root. 12 Antibiotics were not routinely used throughout the perioperative period. Stitches were removed at 2 weeks according to wound healing.…”

“…Although PELD is considered a mainstream technique for the treatment of LDH, it has various risks and complications of its own 11,12 . Among them, infection (wound infection or deep infection) is a thorny issue for orthopaedic surgeons.…”

“…Although PELD is considered a mainstream technique for the treatment of LDH, it has various risks and complications of its own. 11,12 Among them, infection (wound infection or deep infection) is a thorny issue for orthopaedic surgeons. SSI defined as an infection that occurs at or near the surgical incision site within 30 days of surgery can have serious consequences, including prolonged hospital stays, repeat surgery, prolonged morbidity and even death.…”

Correction to: Evaluation of full-endoscopic lumbar discectomy in the treatment of obese adolescents with lumbar disc herniation: a retrospective study

“…Following the publication of the original article [ 1 ] the authors noticed an introduced error in the authors’ footnote during production process. The last author name is incorrect.…”