Percutaneous Endoscopic Lumbar Discectomy For Adolescent Lumbar Disc Herniation

Objective: To investigate the clinical efficacy of percutaneous endoscopic lumbar discectomy(PELD)for adolescent lumbar disc herniation.Methods: We retrospectively reviewed the medical records of 18 adolescent patients(aged 14–18 years old) with LDH from November 2008 to April 2012,including 11 males and 7 females with an average age of 15.9years.The clinical findings and MRI were the main diagnostic methods. The operation time, intraoperative blood loss and length of incision were all recorded. The Visual Analog Scale(VAS)scores of low back pain and leg pain, Oswestry Disability Index(ODI) scores were recorded preoperatively and at 1 day、1 month 、6 months and 1 year after the operation and the latest follow-up respectively, and the statistically significant differences were compared.The clinical outcome was determined by modified Macnab criteria at the final follow-up.Results: The average operation time of each patient was 45min(ranged 30min--65min), the mean length of incision was 7mm(ranged 6--8mm), the mean intraoperative blood loss was 5ml(ranged 3-10ml). No complications such as infection and the injury of blood vessels and nerves occurred. The average follow-up duration was 54.5months with a range of 33 to 76 months. The VAS score of low back pain has been(5.22±1.06) points preoperatively, while was reduced to( 1.89±0.83) 、(1.50±0.86) 、(1.39±0.70) 、(1.06±0.64)and(0.67±0.77)points at 1 day、1 month 、6 months and 1 year after the operation and in the latest follow-up respectively( P<0.05).The VAS score of leg pain has been(7.78±0.73) points preoperatively, while was reduced to(3.17±1.72) 、(2.67±1.46)、(1.61±0.78)、(1.2±0.65) and(0.78±0.55) points at 1 day、1 month 、6 months and 1 year after the operation and the latest follow-up respectively( P<0.05). The ODI score has been(65.6±7.24) points preoperatively, while was reduced to(10.89±4.95) 、(8.02±5.02)、(4.73±4.06)、(4.12±2.99) and(3.50±3.12) points at 1 day、1 month 、6 months and 1 year after the operation and in the latest follow-up respectively( P<0.05). The clinical outcomes in the last follow-up were determined by using a modified Macnab criteria:The last follow-up were excellent in 15 patients, good in 3 patients,which revealed that all the patients had satisfactory result.Conclusion:Percutaneous endoscopic lumbar discectomy(PELD) provides a new choice for adolescent lumbar herniation and provides satisfactory clinical results. PELD is safe and effective for adolescent lumbar disc herniation.