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 Mar 16:16:911-919. doi: 10.2147/JPR.S380945. eCollection 2023.

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.

Keywords: adolescent; lumbar disc herniation; percutaneous endoscopic lumbar discectomy; posterior ring apophysis fracture.

Grants and funding

This study was supported by the National Science Founding of China (No. 81860397 to Xigao Cheng).