Efficacy Analysis of Percutaneous Endoscopic Lumbar Discectomy Combined with PEEK Rods for Giant Lumbar Disc Herniation: A Randomized Controlled Study.

Xiang Gao,Kaiying Tang,Yu Xia,Liang Chen,Keran Wang,Zhengjian Yan,Yu Du,Xun Zhang

doi:10.1155/2020/3401605

Abstract

Objective This study describes a randomized controlled trial that assesses percutaneous endoscopic lumbar discectomy (PELD) combined with a polyetheretherketone (PEEK) rod in patients with GLDH (herniation affecting 50% of the sagittal diameter of the spinal canal) and reports the 2-year follow-up outcome. Methods In all, 243 patients were randomly assigned to undergo PELD or PELD combined with a PEEK rod by generating random numbers with a random number generator. Clinical outcome data, including the numerical rating scale (NRS), were used to assess the patients' back and leg pain, while the Oswestry Disability Index (ODI) was used to quantify pain and disability. Imaging data included intervertebral disc height (IDH), range of motion (ROM), and modified Pfirrmann grades. Results At the final follow-up, the NRS for back and leg pain and the ODI scores were significantly decreased in both groups. The NRS for back pain and the ODI scores in the PELD + PEEK group (1.32 ± 0.70, 14.10 ± 4.74) were better than those in the PELD group (1.91 ± 0.69, 16.93 ± 4.33) (P < 0.05). The IDH of the PELD + PEEK group (10.54 ± 1.62) was significantly higher than that in the PELD group (9.98 ± 1.90) (P < 0.05). The IDH of the PELD + PEEK group (10.54 ± 1.62) was significantly higher than that in the PELD group (9.98 ± 1.90) (P < 0.05). The IDH of the PELD + PEEK group (10.54 ± 1.62) was significantly higher than that in the PELD group (9.98 ± 1.90) (Conclusion For symptomatic patients with GLDH, both PELD and PELD combined with a PEEK rod showed good efficacy. However, the long-term effect of PELD combined with a PEEK rod is better than that of PELD alone. Moreover, PELD combined with a PEEK rod can effectively reduce the recurrence rate. Maximum benefit can be gained if we adhere to strict selection criteria for PELD combined with a PEEK rod.

Highlights

Polyetheretherketone (PEEK) rods are widely used as semirigid fixation systems for nonfusion fixation of the spine [8, 9]. ese rods can effectively maintain the height of the intervertebral space without the adjacent segment disease (ASD) caused by rigid fixation [10, 11]. erefore, we used the PEEK rod semirigid fixation system for the treatment of giant disc herniation. is study analyzed the efficacy of a PEEK rod in the treatment of patients with giant lumbar disc herniation (GLDH) using a randomized clinical trial that was designed to investigate the efficacy of PEEK rods in alleviating pain and improving function in patients with GLDH
We found that the range of motion (ROM) of the percutaneous endoscopic lumbar discectomy (PELD) + PEEK group significantly decreased from 8.32 ± 1.76 to 2.39 ± 0.90, which shows that PEEK rods can provide a “micromotion” of the fixed segments in the in vitro test or in vivo in humans
25 cases of lumbar instability were observed at the final follow-up. is may have caused patients in the PELD group to experience more back pain. erefore, we suggest that patients with GLDH should undergo fixation with PEEK rods during primary surgery

Summary

Introduction

Is study describes a randomized controlled trial that assesses percutaneous endoscopic lumbar discectomy (PELD) combined with a polyetheretherketone (PEEK) rod in patients with GLDH (herniation affecting 50% of the sagittal diameter of the spinal canal) and reports the 2-year follow-up outcome. E NRS for back pain and the ODI scores in the PELD + PEEK group (1.32 ± 0.70, 14.10 ± 4.74) were better than those in the PELD group (1.91 ± 0.69, 16.93 ± 4.33) (P < 0.05). For symptomatic patients with GLDH, both PELD and PELD combined with a PEEK rod showed good efficacy. Extensive intervertebral disc herniation decreases the height of the intervertebral space and causes instability of the spine, which results in chronic lower back pain [6, 7]. Patients were included in the trial after written informed consent was obtained (Figure 1)

Methods

Results

Discussion

Conclusion