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Wu H, Li T, Cao J, He D, Wu T, Liu J, Yuan J, Cheng X. Does Percutaneous Endoscopic Lumbar Discectomy for Adolescent Posterior Ring Apophysis Fracture Accompanied with Lumbar Disc Herniation Have Better Outcome Than Lumbar Disc Herniation Alone? J Pain Res 2023; 16:911-919. [PMID: 36960466 PMCID: PMC10028304 DOI: 10.2147/jpr.s380945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/07/2023] [Indexed: 03/17/2023] Open
Abstract
Objective This study aims to compare the efficacy of percutaneous endoscopic lumbar discectomy (PELD) in treating adolescent posterior ring apophysis fracture (APRAF) accompanied by lumbar disc herniation (LDH) and lumbar disc herniation alone. Methods Herein we present a case series of adolescent patients who underwent PELD surgery from June 2017 to September 2021. All patients were divided into two distinct groups (ie Group A and B), based on their preoperative Computed tomography (CT) scans. Group A included patients with PRAF (type III) accompanied by LDH. Group B patients had LDH alone. The general clinical characteristics, clinical outcomes, and complications in patients from the two groups were assessed and compared. Results Compared to before surgery, the back and leg visual analog scores (VAS) and Oswestry Disability Index (ODI) were markedly improved in both groups' patients at all follow-ups. Notably, no significant differences were observed in the back and leg VAS scores, and ODI values between the two groups at different time points after surgery. The mean intraoperative blood loss was significantly lower in Group B, relative to Group A. The mean operation time was significantly shorter in Group B, compared to Group A. There was no statistically significant difference in complication and recurrence rates between the two groups. Conclusion APRAF (type III) accompanied by LDH and LDH alone can obtain roughly equal surgical effects through PELD surgery and turns out to be a safe and effective surgical approach.
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Affiliation(s)
- Hui Wu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Tao Li
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Jian Cao
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Dingwen He
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Tianlong Wu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Jiahao Liu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Jinghong Yuan
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Xigao Cheng
- Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
- Correspondence: Xigao Cheng, Department of Orthopaedics Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China, 330006, Email
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Percutaneous endoscopic interlaminar discectomy for posterior ring apophyseal fracture accompanied with lumbar disc herniation in a 12-year pediatric diver: a case report. Childs Nerv Syst 2023; 39:275-278. [PMID: 35798908 PMCID: PMC9968678 DOI: 10.1007/s00381-022-05605-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/03/2022] [Indexed: 11/03/2022]
Abstract
Posterior ring apophysis fracture (PRAF), accompanied with lumbar disc herniation (LDH), is a rare occurrence. Owing to its rarity, there is no consensus on the treatment strategy for this condition. Differences mainly encompass the type of decompression method, the need for additional spinal fusion, the need for apophysis fragments or/and disc materials removal, and long-term efficacy, particularly, compared to LDH alone. Hence, the aim of this study was to describe a rare instance of PRAF with LDH in a 12-year-old professional diver, who was successfully treated with percutaneous endoscopic interlaminar discectomy (PEID), and to initiate a discussion involving several meaningful and related factors.
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Zhu G, Xu Y, Cui J, Tang J, Ren H, De L, Jiang X. Cave-in Decompression Technique in Percutaneous Endoscopic Transforaminal Discectomy for Ossification Occupation in Lumbar Spinal Canal: A retrospective analysis of 23 cases. Neurochirurgie 2022; 68:498-503. [PMID: 35477015 DOI: 10.1016/j.neuchi.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/01/2022] [Accepted: 03/18/2022] [Indexed: 11/26/2022]
Abstract
OBJECT Percutaneous endoscopic transforaminal discectomy (PETD) for the treatment of ossification occupation of the lumbar spinal canal is technically demanding. The purpose of this study was to describe an endoscopic cave-in decompression technique in PETD for ossification occupation of the lumbar spinal canal and to report the clinical results. METHODS From May 2018 to June 2020, 23 consecutive cases, diagnosed in our institution as ventral ossification in the lumbar spinal canal and treated with PETD, were evaluated. The endoscopic cave-in decompression technique was performed. We analyzed the clinical outcomes on a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Perioperative data and complications rate were also recorded. RESULTS Mean follow-up was 15.7 ± 2.8 months. Mean preoperative VAS score for low-back pain was 5.65 ± 1.43, and decreased to 0.57 ± 0.5 at final follow-up. Mean preoperative VAS score for leg pain was 5.48 ± 1.38, and decreased to 0.56 ± 0.5 at final follow-up. Mean preoperative ODI score decreased from 33.04 ± 5.28 preoperatively to 8.7 ± 2.54 at last follow-up. One patient experienced transient postoperative hypoesthesia, and 1 developed a mild transient decline in muscle strength; both recovered progressively. Postoperative CT and MRI showed that the ossification was effectively removed and the nerve root and dural mater was completely decompressed in all cases. CONCLUSION The endoscopic cave-in decompression technique in PETD is a safe and effective treatment method for selected patients with ossification occupation of the lumbar spinal canal.
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Affiliation(s)
- Guangye Zhu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Yuerong Xu
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Jianchao Cui
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Jingjing Tang
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Hui Ren
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Liang De
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China
| | - Xiaobing Jiang
- Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510405 Guangzhou, China.
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