Percutaneous Endoscopic Lumbar Discectomy in Treating Calcified Lumbar Intervertebral Disc Herniation

Abstract

Background: We retrospectively analyzed and report the clinical results of percutaneous endoscopic lumbar discectomy (PELD) in treating patients with calcified lumbar intervertebral disc herniation (CLDH).

Methods: The data from 40 patients with CLDH treated with PELD in our hospital from June 2013 to June 2017 were reviewed. Of the 40 patients, 27 (19 men; 8 women; average age, 45.5 ± 7.5 years) had undergone percutaneous endoscopic transforaminal discectomy and 13 (8 men, 5 women; average age, 46.9 ± 6.9 years) had undergone percutaneous endoscopic interlaminar discectomy. The Peak method was used for both groups. The preoperative demographic data of both groups were analyzed. The pre- and postoperative leg visual analog scale scores and Oswestry disability index were compared and complications were evaluated.

Results: All procedures were performed successfully, and follow-up data were obtained for all patients for 24 months. The leg visual analog scale and Oswestry disability index scores at the last follow-up visit had decreased in both groups and were significantly different statistically from the preoperative data. No nerve root injury, intestinal injury, intervertebral disc infection, or recurrence was detected in any patient. Dural tear and cerebrospinal fluid leakage were observed in 3 patients (2, percutaneous endoscopic transforaminal discectomy; 1, percutaneous endoscopic interlaminar discectomy), because of adhesions between the calcification and nerve root. However, their symptoms resolved, and they were discharged after 1 week of bed rest.

Conclusions: With the application of Peak philosophy, PELD is safe and effective in treating patients with CLDH. The use of PELD results in good neurological recovery, pain relief, and a low incidence of complications.

Keywords: Calcification; Clinical efficacy; Lumbar disc herniation; Percutaneous endoscopic lumbar discectomy.