Does Percutaneous Endoscopic Lumbar Discectomy for Adolescent Posterior Ring Apophysis Fracture Accompanied with Lumbar Disc Herniation Have Better Outcome Than Lumbar Disc Herniation Alone?

Abstract

Objective

This study aims to compare the efficacy of percutaneous endoscopic lumbar discectomy (PELD) in treating adolescent posterior ring apophysis fracture (APRAF) accompanied by lumbar disc herniation (LDH) and lumbar disc herniation alone.

Methods

Herein we present a case series of adolescent patients who underwent PELD surgery from June 2017 to September 2021. All patients were divided into two distinct groups (ie Group A and B), based on their preoperative Computed tomography (CT) scans. Group A included patients with PRAF (type III) accompanied by LDH. Group B patients had LDH alone. The general clinical characteristics, clinical outcomes, and complications in patients from the two groups were assessed and compared.

Results

Compared to before surgery, the back and leg visual analog scores (VAS) and Oswestry Disability Index (ODI) were markedly improved in both groups’ patients at all follow-ups. Notably, no significant differences were observed in the back and leg VAS scores, and ODI values between the two groups at different time points after surgery. The mean intraoperative blood loss was significantly lower in Group B, relative to Group A. The mean operation time was significantly shorter in Group B, compared to Group A. There was no statistically significant difference in complication and recurrence rates between the two groups.

Conclusion

APRAF (type III) accompanied by LDH and LDH alone can obtain roughly equal surgical effects through PELD surgery and turns out to be a safe and effective surgical approach.

Keywords:

• adolescent
• posterior ring apophysis fracture
• percutaneous endoscopic lumbar discectomy
• lumbar disc herniation

Data Sharing Statement

The data of this study can be obtained by contacting the corresponding author, Xigao. Cheng, at [email protected].

Consent for Publication

Since the patients were minors, written informed consent was obtained from their parents for publication of this research and accompanying images and pictures.

Ethical Statement

This study was performed following the principles of the Declaration of Helsinki and was conducted according to the National Ethics Guidelines Statement. Informed consent was obtained from all participants or their parents. This study was supported by the ethics committee of the Second Affiliated Hospital of Nanchang University (No. Review [2014] No. (071).).

Disclosure

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Funding

This study was supported by the National Science Founding of China (No. 81860397 to Xigao Cheng).