A suture technique combining annulus fibrosis with posterior longitudinal ligament for lumbar disc herniation under endoscopy

Purpose: To investigate the clinical feasibility, efficacy and safety of a suture technique combining annulus fibrosus with posterior longitudinal ligament under full endoscopy in patients with lumbar disc herniation.

Methods: Retrospective case-control study. A total of 412 patients with lumbar disc herniation treated in our hospital from January 2020 to November 2022 were enrolled and analyzed. There were 208 males and 204 females, aged from 26 to 54 years old(average 39.9 ± 5.1). 208 patients were treated with combining annulus fibrous suture with posterior longitudinal ligament after percutaneous lumbar discectomy(PELD) (observation group)0.204 patients were treated with percutaneous lumbar discectomy(PELD) alone(control group). Operation time, blood loss, Visual Analogue scale(VAS), Oswestry disability index(ODI),Japanese Orthopedic Association(JOA), modified MacNab criteria and imaging examination were used to evaluate.

Results: All the 412 patients successfully completed the surgery. Complete follow-up time was 12-18 months, with an average of 15.2 ± 1.6 months. Postoperative symptoms were all significantly relieved. There was no statistically significant difference in baseline data between groups (P > 0.05). The scores of VAS,ODI and JOA at different postoperative follow-up visits were significantly lower than those before surgery (P < 0.05). There was significant difference in each group before and after surgeries (P < 0.05). The postoperative recurrence rates and reoperation rates between groups were significant different(P < 0.05). According to MacNab, the excellent and good rate was 96.2 % (200/208) in observation group and 90.7 % (185/204) in control group(P < 0.05).

Conclusions: The suture technique combining annulus fibrosus with posterior longitudinal ligament under full endoscopy in patients with lumbar disc herniation has satisfactory short- and mid-term clinical effect,and can effectively reduce postoperative recurrence rate, which is a safe and ideal suture technique for annulus fibrosus rupture.

Clinical trial number: not applicable.