One-Stage Percutaneous Endoscopic Lumbar Discectomy for Symptomatic Double-Level Contiguous Adolescent Lumbar Disc...

To assess the clinical efficacy of one-stage percutaneous endoscopic lumbar discectomy (PELD) for symptomatic double-level contiguous adolescent lumbar disc herniation (ALDH).

This retrospective study included 16 patients who presented with back and/or leg pain due to double-level disc herniation underwent PELD for symptomatic lumbar disc herniation (0.27%,16/5877) from January 2014 to September 2019. After follow-up period of 17.3 months in average, numeric rating scale (NRS) scores and modified Macnab criteria were used to assess the preoperative and postoperative clinical results. Quantitative data were expressed as mean standard deviation (SD) and the data for the variation in the NRS scores before and after the operation were compared using the Wilcoxon two-sample test. Analyses were performed with IBM SPSS Statistics for Windows, version 19.0 (IBM, Armonk, NY, USA). Values of P < 0.05 were considered significantly different.

There were 11 male and 5 female patients, with an average age of 19.3 years (range, 15-22 years). One case affected the L₂ - L₃ /L₃ -L₄ level, seven cases affected the L₃ - L₄ /L₄ - L₅ level, and eight cases affected the L₄ - L₅ /L₅ -S₁ level. The NRS scores decreased significantly in both early and late follow-up evaluations and these scores demonstrated significant improvement in late follow-up (P < 0.05). For the modified Macnab criteria, the final outcome results were excellent in 14 patients (87.5%), good in 1 patient (6.25%), fair in 1 patient (6.25%), and the overall success rate was 93.75%.

This study's data suggest that one-stage PELD is promising treatment strategy for selected symptomatic double-level contiguous adolescent lumbar disc herniation.