Factors of Intervertebral Disc Rehydration after Percutaneous Endoscopic Lumbar Discectomy

Abstract

Percutaneous endoscopic lumbar discectomy (PELD) is an effective surgical option for lumbar disc herniation (LDH) but is associated with lumbar intervertebral disc rehydration in some patients. However, the incidence of rehydration is not clearly, and only a few studies have discussed this in detail. The study aimed at investigating the factors influencing intervertebral disc rehydration in a series of patients with LDH who underwent PELD. Ninety-six patients with single-level LDH who underwent PELD at Shenzhen Traditional Chinese Medicine Hospital from October 2013 to May 2021 were studied. The relevant data of the patients were recorded such as age, course of disease, sex, body mass index (BMI), diabetes mellitus, hypertension, smoking status, and postoperative exercise; imaging factors such as Modic changes of adjacent vertebrae at surgical level, Pfirrmann grade, degree of disc herniation (Komori classification), and spinal canal morphology; peripheral blood factors such as blood routine parameters, C-reactive protein level, erythrocyte sedimentation rate (ESR), and Th1/Th2 subgroup analysis; and operation-related factors such as surgical approach, length of operation, and amount of blood loss. Univariate analysis and binary logistic regression analysis were conducted to determine the influence of the above parameters on disc rehydration. Our results showed that Young patients with intervertebral disc herniation with a short course of disease, no smoking history, not overweight, no history of diabetes, with intervertebral disc herniation type of Komori Type C, Pfirrmann grade IV, and no adjacent vertebral Modic changes, coupled with high levels of mononuclear cells and TNF-α in peripheral blood, may be more prone to rehydration after PELD.