Correlation between Disc Imaging Observations and Clinical Efficacy after Percutaneous Endoscopic Lumbar Discectomy:...

Area of Science:

• Spine surgery
• Radiology
• Orthopedics

Background:

• Percutaneous endoscopic lumbar discectomy (PELD) is a common procedure for lumbar disc herniation (LDH).
• The relationship between post-PELD disc morphology changes and clinical outcomes remains under-investigated.

Purpose of the Study:

• To investigate the correlation between intervertebral disc morphological changes and postoperative outcomes after PELD.
• To identify specific morphological parameters influencing surgical efficacy.
• To establish an evidence-based foundation for assessing PELD outcomes.

Main Methods:

• 98 patients undergoing PELD had pre- and post-operative lumbar spine MRI (3 months).
• Morphological parameters (disc height, height index, protrusion distance, area, circumference) were measured in sagittal and cross-sectional planes.
• Clinical outcomes assessed via Oswestry Disability Index (ODI), VAS (back/leg pain), and JOA scores at 3, 6, and 12 months.

Main Results:

• Disc area and circumference changes showed no association with efficacy.
• Variations in disc height and protrusion distance negatively correlated with VAS back pain scores at 3 and 6 months post-surgery.
• No significant differences in the relationship between disc morphology changes and efficacy were found across different LDH types.

Conclusions:

• Post-PELD disc height and herniation distance changes in the sagittal plane offer a morphological basis for assessing short-term efficacy.
• Cross-sectional disc parameters (area, circumference) are not linked to PELD outcomes.
• The impact of disc morphologic changes on postoperative efficacy is consistent across various LDH types.