Efficacy of Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Patients Undergoing Lumbar Disc Herniation With Positive Nerve Root Sedimentation Sign: a Retrospective Case-Control Study

Abstract

Background: To investigate the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of patients who were diagnosed with lumbar disc herniation (LDH) with positive nerve root sedimentation sign (NRSS).Methods: A total of 86 patients who underwent LDH were recruited and divided into NRSS-positive group (n=49) and NRSS-negative group(n=37). The visual analog scale (VAS), Japanese Orthopaedic Association (JOA), and Oswestry Disability Index (ODI) were used to evaluate the low back pain and functional recovery and were compared between the two groups.Results: There were no significant differences in the demographic parameters between the two groups. The average area of the dural sac compression in the NRSS-positive group was significantly higher than that in the NRSS-negative group. Patients with a positive NRSS showed a better low back pain relief than those with a negative NRSS at 1 week and 1 month after surgery. The JOA and ODI in the NRSS-positive group were better than those in the NRSS-negative group at 3 months and 6 months postoperatively. The apparent efficiency of JOA and the excellent and good rate of ODI in the negative group was lower than that in the positive group at 6 months after surgery. Conclusions: Patients undergoing LDH with a positive NRSS showed better pain relief and functional recovery than those with a negative NRSS. The present study suggested that NRSS might be a valuable sign and associated with better clinical outcomes in patients undergoing LDH with the treatment of PTED.