ArticleJournal of orthopaedic surgery and research2025
Clinical advantages of percutaneous endoscopic lumbar discectomy combined with lumbar hyperextension pressurization in the treatment of L4/5 single-segment lumbar disc herniation.
Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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6 authors.
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Abstract
backgroundAlthough percutaneous endoscopic lumbar discectomy (PELD) has become a classic operation for the treatment of lumbar disc herniation (LDH), its high recurrence rate remains a major problem that needs to be addressed. lumbar hyperextension pressurization (LHP) can promote the further herniation of LDH. The purpose of this study was to explore the application advantages of LHP in PELD and to clarify whether LHP-PELD is better than traditional PELD.
methodsPatients with L4/5 single-segment LDH who underwent surgical treatment were retrospectively analyzed. 23 cases were treated with LHP-PELD and 28 cases were treated with traditional PELD, and were followed up for at least 12 months. The intraoperative blood loss (IBL), operation time (OT), postoperative hospital stay (PHS), visual analogue scale (VAS), Oswestry Disability Index (ODI), recurrence rate, MacNab score, intervertebral disc height (IDH), the cross-sectional area of the spinal canal (CSAC), the cross-sectional area of the dural sac (CSAS), the residual rate of the nucleus pulposus (RRNP), and the residual area of the nucleus pulposus (RANP) were compared between the two groups.
resultsThere were no significant differences in OT, IBL, and PHS between the two groups (p > 0.05). The VAS-Leg of the LHP-PELD group was significantly lower than the traditional PELD group on the postoperative 3rd day (p < 0.05), but there was no significant difference between the two groups at 3 months, 6 months, and 12 months postoperatively (p > 0.05). There was no significant difference in VAS-Back, ODI, MacNab, recurrence rate, and IDH between the two groups (p > 0.05). The CSAC and CSAS in the LHP-PELD group were significantly higher than the PELD group (p < 0.05). However, the RRNP and RANP in the LHP-PELD group were significantly lower than the PELD group (p < 0.05).
conclusionCompared with traditional PELD, LHP-PELD can significantly reduce the residual nucleus pulposus, expand the area of the spinal canal and the dural sac, and significantly reduce the pain of patients in the short term postoperatively. It has better clinical efficacy and radiological outcomes and may to some extent reduce recurrence rates and the need for secondary surgery.
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