Therapeutic effect of percutaneous endoscopic lumbar discectomy on lumbar disc herniation and its effect on oxidative stress in patients with lumbar disc herniation

Chang, Feng Chi; Zhang, Ting; Gao, Gang; Chen, Yu; Liu, Ping; Zuo, Genle; Huang, Xinhu

doi:10.3892/etm.2017.5348

Cited by 12 publications

(16 citation statements)

References 18 publications

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“…Another interesting finding of this study was that patients in minimally invasive group had lower levels of postoperative inflammatory response and faster immune function recovery. Chang et al (22) drew similar conclusions in their study. The levels of inflammatory factors TNF-α and CRP in patients undergoing percutaneous endoscopic lumbar discectomy were also significantly lower than those in patients undergoing open discectomy.…”

Section: Discussionsupporting

confidence: 68%

Endoscopic removal of nucleus pulposus of intervertebral disc on lumbar intervertebral disc protrusion and the influence on inflammatory factors and immune function

Zhang

Zhu

et al. 2019

Exp Ther Med

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Endoscopic removal of nucleus pulposus (NP) of intervertebral disc (IVD) on lumbar intervertebral disc protrusion (LIDP) and its influence on inflammatory factors and immune function were explored. A total of 145 patients with LIDP admitted to The First Affiliated Hospital of Bengbu Medical College from June 2017 to December 2018 were selected and electively treated, in which 87 patients were treated with fenestration discectomy (fenestration group) and 58 patients were treated with endoscopic removal of NP of IVD (minimally invasive group). Effects on patients in the two groups within 6 months after surgery were evaluated by modified MacNab score; differences in surgical related indexes and incidence rates of complications between the two groups were compared; the Oswestry dysfunction score and VAS pain score before treatment, and 1, 3 and 6 months after treatment, and changes of cellular levels of TNF-α, IL-4, IL-6, CD3+, CD4+, and CD8+ before treatment, and 24 and 48 h after surgery were evaluated. Length of surgical incision, intraoperative blood loss, time of operation, time in bed, and hospital stays of patients in minimally invasive group were lower than those in the fenestration group (P<0.05). The Oswestry score and VAS score of patients in minimally invasive group 1, 3 and 6 months after surgery were lower than those in fenestration group (P<0.05). The incidence rate of spinal instability and overall incidence of complications of patients in minimally invasive group were significantly lower than those in fenestration group (P<0.05). Levels of TNF-α and IL-6 of patients in the minimally invasive group 24 and 48 h after surgery were lower than those in the fenestration group (P<0.05) and cellular levels of IL-4, CD3+, CD4+, and CD8+ were higher (P<0.05). In conclusion, endoscopic removal of NP of IVD has good therapeutic effects in patients with LIDP. It reduces inflammation and suppresses immune function with higher safety, worthwhile for clinical use.

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Section: Discussionsupporting

confidence: 68%

Endoscopic removal of nucleus pulposus of intervertebral disc on lumbar intervertebral disc protrusion and the influence on inflammatory factors and immune function

Zhang

Zhu

et al. 2019

Exp Ther Med

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“…During the follow-up, the clinical outcomes were better in the PELD group, and the levels of C-reactive protein, creatine phosphokinase, and interleukin 6 were all lower in the PELD group than in the OD group. Another study showed similar results [21]; however, opposite results have also been reported [22]. PELD was considered less invasive to soft tissue and with a faster recovery.…”

Section: Discussionmentioning

confidence: 58%

Surgical Outcomes for Upper Lumbar Disc Herniation: Decompression Alone versus Fusion Surgery

Lin

Wang

Chang

et al. 2019

JCM

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Upper lumbar herniated intervertebral disc (HIVD), defined as L1-2 and L2-3 levels, presents with a lower incidence and more unfavorable surgical outcomes than lower lumbar levels. There are very few reports onthe appropriate surgical interventions for treating upper lumbar HIVD. This study aimed to evaluate the surgical outcome of decompression alone, when compared with spinal fusion surgery. A retrospective study involving a total of 7592 patients who underwent surgery due to HIVD in our institution was conducted. A total of 49 patients were included in this study: 33 patients who underwent decompression-only surgery and 16 patients who underwent fusion surgery. Demographic data, perioperative information, and functional outcomes were recorded. The visual analog scale (VAS) scores showed improvement in both groups postoperatively. The three-month postoperative Oswestry Disability Index score was significantly better in the fusion group. Additionally, 10 patients (76.9%) in the decompression group and 5 patients (83.3%) in the fusion group reported improvement in preoperative motor weakness. The final “satisfactory” rate was 66.7% in the decompression group and 93.8% in the fusion group (p = 0.034). The overall surgical outcomes of patients with upper lumbar HIVD were satisfactory in this study without any major complications. More reliable satisfactory rates and better functional scores at the three-month postoperative follow-up were reported in the fusion group.

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“…Eight studies reported the data of recurrence rate. [ 44 , 45 , 47 – 50 , 54 , 56 ] The recurrence rates in the PELD and other surgical intervention groups were 7.57% and 4.38%, respectively. The aggregated results of these studies suggested that PELD was associated with a significantly higher recurrence rate than other surgical interventions (RR = 1.65, 95%CI: 1.08, 2.52; P = .021) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Ten of the included trials in the present study were of cohort design, [ 44 – 47 , 50 , 52 – 54 , 56 , 57 ] and 4 were RCT design. [ 48 , 49 , 51 , 55 ] Among the included studies, four compared PELD with OLM, [ 44 , 46 , 47 , 50 ] three compared PELD with MIS-TLIF, [ 45 , 52 , 54 ] three compared PELD with MED, [ 45 , 55 , 57 ] three compared PELD with microsurgical discectomy, [ 48 , 49 , 51 ] one compared PELD with open discectomy, [ 56 ] and one compared PELD with fenestration discectomy. [ 53 ] Most of the included studies enrolled adult patients with a mean age between 33.1 and 57.2 years, whereas in the study of Ahn SS, et al, [ 47 ] they enrolled young adults with an age between 20–25 years.…”

Section: Resultsmentioning

confidence: 99%

Percutaneous endoscopic lumbar discectomy compared with other surgeries for lumbar disc herniation

et al. 2021

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Objective: This meta-analysis was performed to investigate whether percutaneous endoscopic lumbar discectomy (PELD) had a superior effect than other surgeries in the treatment of patients with lumbar disc herniation (LDH). Method: We searched PubMed, Embase, and Web of Science through February 2018 to identify eligible studies that compared the effects and complications between PELD and other surgical interventions in LDH. The outcomes included success rate, recurrence rate, complication rate, operation time, hospital stay, blood loss, visual analog scale (VAS) score for back pain and leg pain, 12-item Short Form Health Survey (SF12) physical component score, mental component score, Japanese Orthopaedic Association Score, Oswestry Disability Index. A random-effects or fixed-effects model was used to pool the estimate, according to the heterogeneity among the included studies. Results: Fourteen studies (involving 2,528 patients) were included in this meta-analysis. Compared with other surgeries, PELD had favorable clinical outcomes for LDH, including shorter operation time (weight mean difference, WMD=−18.14 minutes, 95%CI: −25.24, −11.05; P < .001) and hospital stay (WMD = −2.59 days, 95%CI: −3.87, −1.31; P < .001), less blood loss (WMD = −30.14 ml, 95%CI: −43.16, −17.13; P < .001), and improved SF12- mental component score (WMD = 2.28, 95%CI: 0.50, 4.06; P = .012)) and SF12- physical component score (WMD = 1.04, 95%CI: 0.37, 1.71; P = .02). However, it also was associated with a significantly higher rate of recurrent disc herniation (relative risk [RR] = 1.65, 95%CI: 1.08, 2.52; P = .021). There were no significant differences between the PELD group and other surgical group in terms of success rate (RR = 1.01, 95%CI: 0.97, 1.04; P = .733), complication rate (RR = 0.86, 95%CI: 0.63, 1.18; P = .361), Japanese Orthopaedic Association Score score (WMD = 0.19, 95%CI: −1.90, 2.27; P = .861), visual analog scale score for back pain (WMD = −0.17, 95%CI: −0.55, 0.21; P = .384) and leg pain (WMD = 0.00, 95%CI: −0.10, 0.10; P = .991), and Oswestry Disability Index score (WMD = −0.29, 95%CI: −1.00, 0.43; P = .434). Conclusion: PELD was associated with better effects and similar complications with other surgeries in LDH. However, it also resulted in a higher recurrence rate. Considering the potential limitations in the present study, further large-scale, well-performed randomized trials are needed to verify our findings.

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Therapeutic effect of percutaneous endoscopic lumbar discectomy on lumbar disc herniation and its effect on oxidative stress in patients with lumbar disc herniation

Cited by 12 publications

References 18 publications

Endoscopic removal of nucleus pulposus of intervertebral disc on lumbar intervertebral disc protrusion and the influence on inflammatory factors and immune function

Endoscopic removal of nucleus pulposus of intervertebral disc on lumbar intervertebral disc protrusion and the influence on inflammatory factors and immune function

Surgical Outcomes for Upper Lumbar Disc Herniation: Decompression Alone versus Fusion Surgery

Percutaneous endoscopic lumbar discectomy compared with other surgeries for lumbar disc herniation

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