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Background. Patients with lumbar disc herniation (LDH) may present with motor disorders and various sensory disorders, among which pain and numbness are the most common ones. Percutaneous endoscopic lumbar discectomy (PELD) is reported to be both safe and effective. However, most of the previous studies focused on the recovery of pain, and the relief extent of numbness and weakness has rarely been reported. The Sciatica Bothersomeness Index (SBI) is a self-assessment tool for LDH patients. It has demonstrated acceptable reliability, construct validity, and responsiveness. Objectives. Our aim was to explore the curative effect of percutaneous endoscopic lumbar discectomy and to compare the various extent of relief among pain, numbness, and weakness. Methods. The medical records of patients admitted for LDH from September 2016 to December 2018 were collected, and the patients were followed up for 3 months to evaluate the relief of their clinical symptoms. Preoperative and postoperative total scores and subitem scores of SBI were compared to evaluate the relief of pain, numbness, and weakness. Surgical outcomes of PELD were evaluated by the Nakai score, and patients were divided into two groups accordingly, which were the relief group (excellent and good in the Nakai score) and the less relief group (fair and poor in the Nakai score). Risk factors for PELD outcomes and preoperative presence of numbness and/or weakness were analyzed by the logistic model, and p value less than 0.05 was considered significant. Results. A total of 86 patients met the inclusion criteria and acquired 3 months follow-up. Relief extent of pain, numbness, and weakness, was 82%, 41%, and 21%, respectively. There were 71 cases in the relief group and 15 cases in the less relief group. Results of the logistic regression analysis showed that the preoperative pain score of SBI (p=0.002; OR: 1.647 (1.199–2.261)) was a relatively independent risk factor for PELD outcomes, and multiplicativity of duration of preoperative symptoms and imaging grade [p=0.004; OR: 1.015 (1.005–1.026)] was a relatively independent risk factor for preoperative presence of numbness and/or weakness. Conclusions. PELD had a good curative effect in the treatment of LDH. Patients of LDH recovered best from pain, followed by numbness and weakness after PELD. Higher level of patients self-reported preoperative pain indicated a better surgical outcome for LDH patients, and preoperative long duration of symptoms together with a severe compression of nerve root significantly increased the risk of presenting numbness and/or weakness.

Spinal balance assessed by gravity line did not provide a better correlation with HRQOL than C7 PL. Loss of sacral slope and retroverted pelvis are commonly seen in adult scoliosis and are not significantly changed by surgical treatment, including restoration of lumbar lordosis and sagittal balance.

BackgroundSpine surgery is widely accepted as an effective management for patients with lumbar disc herniation; however, the factors influencing intraoperative procedure and prognosis are not fully understood. The present study was aimed to identify the factors influencing intraoperative blood loss, postoperative drainage volume, and recovery in patients undergoing spinal surgery.MethodsWe retrospectively analyzed the clinical data of 183 consecutive patients with lumbar disc herniation who underwent spine surgery. The clinical characteristics, operation procedure, and outcome were documented and the correlations were analyzed.ResultsThere were significant differences between one-level and two-level operations in the bleeding volumes of male (P = 0.005) and female (P = 0.002) patients, and in final drainage of male (P = 0.043) and female (P = 0.003) patients. The blood loss was correlated with the operation duration. There were differences in intraoperative bleeding and final drainage between groups with one-level and two-level operations. Additionally, there were differences in intraoperative autologous blood transfusion among various groups. There were significant differences in intraoperative bleeding between autologous blood transfusion and non-transfusion groups.ConclusionsThe key factors affecting the intraoperative blood loss and postoperative drainage volume include operation methods, operation duration, blood-transfusion modes, and usage of anticoagulants. These results should be taken into consideration in the attempt to optimize operation procedure and improve post-operative recovery.

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