Comparison of Percutaneous Transforaminal Endoscopic Decompression and Transforaminal Lumbar Interbody Fusion in the Treatment of Single-Level Lumbar Disc Herniation with Modic Type I Changes

Li, Pengfei; Yang, Feiya; Tong, Yuexin; Chen, Ying; Song, Youxin

doi:10.2147/jpr.s338342

Cited by 9 publications

(3 citation statements)

References 36 publications

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“…There are several treatment options available for herniation, with segmental fusion being an established method that provides satisfactory short-term results. However, these techniques are invasive, costly, and can potentially create new problems by altering the biomechanical properties of the spine, leading to adverse effects on adjacent levels [ 3 , 17 , 18 ]. As a result, minimally invasive techniques are becoming increasingly popular, with percutaneous endoscopic lumbar discectomy (PELD) being a representative approach.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the clinical efficacy of visualization of percutaneous endoscopic lumbar discectomy combined with annulus fibrosus suture in lumbar disc herniation

Xi,

Wang,

et al. 2024

Neurosurg Rev

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The objective of this study is to compare the clinical effectiveness of visualization of percutaneous endoscopic lumbar discectomy (VPELD) combined with annulus fibrosus suture technique and simple percutaneous endoscopic lumbar discectomy (PELD) technique in the treatment of lumbar disc herniation. A retrospective analysis was conducted on 106 cases of lumbar disc herniation treated with foraminoscopic technique at our hospital from January 2020 to February 2022. Among them, 33 cases were treated with VPELD combined with annulus fibrosus suture in group A, and 73 cases were treated with PELD in group B. The preoperative and postoperative visual analogue scale (VAS), functional index (Oswestry Disability Index, ODI), healing of the annulus fibrosus, intervertebral space height, and postoperative recurrence were recorded and compared between the two groups. All patients underwent preoperative and postoperative MRI examinations, and the average follow-up period was 12 ± 2 months. Both groups showed significant improvements in postoperative VAS and ODI scores compared to the preoperative scores (P < 0.05), with no statistically significant difference between the groups during the same period (P > 0.05). There was no significant decrease in intervertebral space between the two groups after surgery (P > 0.05). Group A showed significantly lower postoperative recurrence rate and better annulus fibrosus healing compared to group B (P < 0.05). The VPELD combined with annulus fibrosus suture technique is a safe, feasible, and effective procedure for the treatment of lumbar disc herniation. When the indications are strictly adhered to, this technique can effectively reduce the postoperative recurrence rate and reoperation rate. It offers satisfactory clinical efficacy and can be considered as an alternative treatment option for eligible patients.

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Section: Discussionmentioning

confidence: 99%

Analysis of the clinical efficacy of visualization of percutaneous endoscopic lumbar discectomy combined with annulus fibrosus suture in lumbar disc herniation

Xi,

Wang,

et al. 2024

Neurosurg Rev

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“…We do recognise that having published their review protocol in Prospero they had limited freedom to do so. Unfortunately, Herlin et al is often being inappropriately cited as demonstrating no association between LBP and MC without acknowledging its limitations [30][31][32][33][34][35][36][37][38], but others do cite it in a more appropriate nuanced way [23,[39][40][41][42][43][44][45][46][47][48][49].…”

Section: Discussionmentioning

confidence: 99%

“…Papers citing Herlin et al were identified using Pub-Med [23,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. The literature was searched through PubMed with the keywords "MRI (back pain) association Modic" restricted to the last 5 years and identified 135 articles.…”

Section: Methodsmentioning

confidence: 99%

Modic changes as seen on MRI are associated with nonspecific chronic lower back pain and disability

Czaplewski,

Rimmer,

McHale

et al. 2023

J Orthop Surg Res

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Background Estimating the contribution of endplate oedema known as Modic changes to lower back pain (LBP) has been the subject of multiple observational studies and reviews, some of which conclude that the evidence for an association of Modic change with LBP is uncertain while others demonstrate a clear link. The clinical trials demonstrating the benefit of basivertebral nerve ablation, a therapeutic intervention, in a tightly defined homogenous patient group with chronic LBP and Modic changes type 1 or type 2, provides further evidence for the contribution of Modic changes to LBP and shows that in these subjects, nerve ablation substantially reduces pain and disability. These interventional studies provide direct evidence that Modic changes can be associated with lower back pain and disability. This review set out to explore why the literature to date has been conflicting. Methods A narrative, forensic, non-systematic literature review of selected articles to investigate why the published literature investigating the association between Modic imaging changes and chronic low back pain is inconsistent. Results This review found that previous systematic reviews and meta-analyses included both heterogeneous study designs and diverse patient syndromes resulting in an inconsistent association between Modic changes and nonspecific chronic lower back pain. Re-analysis of literature data focussing on more homogenous patient populations provides clearer evidence that Modic changes are associated with nonspecific chronic lower back pain and that type 1 Modic changes are more painful than type 2. Conclusions Studies using tightly defined homogenous patient groups may provide the best test for association between MRI-findings and pain and disability. Clinical benefit of basivertebral nerve ablation observed in randomised controlled trials further supports the association between type 1 and type 2 Modic changes with pain and disability.

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Robustly Injectable Tetra‐PEG Hydrogel Sealants for Annulus Fibrosus Repair

Tang,

Li,

Liu

et al. 2024

Adv Healthcare Materials

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Discectomy serves as the primary therapeutic approach for lumbar disc herniation, but the annular fibrosus defects after discectomy may lead to recurrence of disc herniation. Despite recent advances in bioinspired adhesives to seal the AF defect, the growing popularity of endoscopic discectomy has put forward high requirements for the tissue bioadhesives with rapid injectability, easy operation, and robust tissue adhesion in underwater environments. Herein, a rapidly in situ forming injectable tetra‐PEG bioadhesive (ISG) comprising of FDA‐approved tetra‐armed poly (ethylene glycol) amine (tetra‐PEG‐NH2) and tetra‐armed poly (ethylene glycol) succinimidyl glutarate (tetra‐PEG‐SG) for the sutureless closure of AF defects, is reported. Relying on quick ammonolysis reaction between N‐hydroxysuccinimide (NHS)‐ester of tetra‐PEG‐SG polymer and amine groups of tetra‐PEG‐NH2 polymer and tissue proteins, the uniform networks are formed within seconds with easy injection, efficient waterproofness, instant tissue adhesion, and durable compliance. The goat lumbar discectomy model was used to assess the effect of ISG hydrogels in vivo. The results reveal that the resultant ISG bioadhesive can effectively maintain the disc height, fuse with the host tissue, ameliorate IVD degeneration, and retain the initial biomechanics. Together, this study provides an efficient strategy of in situ injectable glue for the minimally invasive treatment of AF defects.

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Comparison of Percutaneous Transforaminal Endoscopic Decompression and Transforaminal Lumbar Interbody Fusion in the Treatment of Single-Level Lumbar Disc Herniation with Modic Type I Changes

Cited by 9 publications

References 36 publications

Analysis of the clinical efficacy of visualization of percutaneous endoscopic lumbar discectomy combined with annulus fibrosus suture in lumbar disc herniation

Analysis of the clinical efficacy of visualization of percutaneous endoscopic lumbar discectomy combined with annulus fibrosus suture in lumbar disc herniation

Modic changes as seen on MRI are associated with nonspecific chronic lower back pain and disability

Robustly Injectable Tetra‐PEG Hydrogel Sealants for Annulus Fibrosus Repair

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