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. 2020 Feb 27;15(1):83.
doi: 10.1186/s13018-020-01608-7.

Effect of time to first ambulation on recurrence after PELD

Fengwei Qin  1 , Zhaofei Zhang  2 , Caixia Zhang  3 , Yonghui Feng  2 , Sineng Zhang  2
Affiliations

Effect of time to first ambulation on recurrence after PELD

Fengwei Qin et al. J Orthop Surg Res. .

Abstract

Study design: Retrospective cohort study.

Objective: To evaluate the effect of time to first ambulation on recurrence after percutaneous endoscopic lumbar discectomy (PELD).

Methods: From July 2017 to August 2018, 90 patients with lumbar intervertebral disc herniation underwent PELD surgery. According to the initial walking time, i.e., the time until the patient could walk after the operation, the operations were divided into three groups: early stage, middle stage, and late stage. The follow-up period was 3 months, and complete follow-up data were obtained. The visual analog scale (VAS) and Oswestry disability index (ODI) scores before the operation, at first ambulation, 1 month after the operation, and 3 months after the operation and the recurrence and incidence rates of high magnetic resonance imaging (MRI) signal in the vertebral endplate area were recorded after the operation.

Results: The success rate was 100% for these 90 cases. The VAS and ODI scores at the first ambulation after the operation significantly improved compared with those before the operation, and the difference was statistically significant. The improvements in the lumbar VAS and ODI scores of the middle- and late-stage groups were better than that of the early-stage group at 1 and 3 months after the operation, and the differences were statistically significant; however, there was no significant difference between the middle- and late-stage groups. The postoperative recurrence rate and rate of high MRI signal in the vertebral endplate area were significantly higher in the early-stage group than in the other two groups, and the difference was statistically significant.

Conclusion: The time to first ambulation after PELD is an important factor affecting the curative effect of the operation. Early ambulation may be one of the factors affecting recurrence after PELD.

Keywords: First ambulation time; Lumbar intervertebral disc herniation; PELD; Recurrence.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The patient was a 36-year-old female and had a protrusion in the posterior left portion of the L4/5 interverbral discs. a X-ray of anterior and posterior lumbar spine before operation. b Preoperative lateral X-ray of lumbar spine. c In the cross-section, CT revealed a protrusion in the posterior left portion of the L4/5 interverbral discs, which compressed the left L5 nerve root. d CT revealed a left L4/5 interverbral disc protrusion in the sagittal section. e MRI revealed a left L4/5 interverbral disc protrusion in the sagittal section. f In the cross-section, it revealed a protrusion in the posterior left portion of the L4/5 interverbral discs, which compressed the left L5 nerve root. g Placement of the working channel during the operation (anteroposterior film). h Placement of the working channel during the operation (lateral film). i The left L5 nerve root was exposed during the operation
Fig. 2
Fig. 2
The patient was a 75-year-old female (group E) and had a protrusion in the posterior right portion of the L4/5 interverbral discs. a MRI revealed a right L4/5 interverbral disc protrusion in the sagittal section. b In the cross-section, it revealed a protrusion in the posterior right portion of the L4/5 interverbral discs, which compressed the right L5 nerve root. c Three months after the operation, MRI revealed high signal in the L4/5 vertebral endplate area. d In the cross-section, it revealed the high signal intensity in the horizontal nerve root canal of the left L4/5 intervertebral disc
Fig. 3
Fig. 3
The patient was a 32-year-old male (group L) and had a protrusion in the posterior left portion of the L5/S1 interverbral discs. a MRI revealed a left L5/S1 interverbral disc protrusion in the sagittal section. b In the cross-section, it revealed a protrusion in the posterior left portion of the L5/S1 interverbral discs, which compressed the left S1 nerve root. c, d Three months after the operation, in the sagittal section and the transverse section, it revealed no significant protrusion in the L5/S1 interverbral discs, and the nerve roots were not compressed
Fig. 4
Fig. 4
a, b, c Comparison of the lumbar pain and leg pain visual analog scale and ODI by the time in the three groups. d Comparisons of the incidence rate of high MRI signal among the three groups
See this image and copyright information in PMC

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