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Updated: Jun 19, 2026
Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
Full-endoscopic posterior longitudinal ligament coverage suturing for lumbar disc herniation with annular defects
Quan Zhang1, Bo He2,1, Zijin Liu3
1Xuzhou Clinical School of Xuzhou Medical University, Department of Orthopedic Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu, 221009, China.
Background:
To investigate the clinical efficacy of full-endoscopic posterior longitudinal ligament (PLL) coverage suturing in the area of the defective annulus fibrosus for the treatment of lumbar disc herniation (LDH).
Methods:
Retrospective analysis of patients who underwent full-endoscopic surgery for LDH in our hospital from March 2018 to July 2023, there were 56 cases presented with partial defects of the annulus fibrosus detected microscopically. Among these, 34 cases were treated with full-endoscopic lumbar discectomy alone (control group), whereas 22 cases were treated with posterior longitudinal ligament coverage of annulus fibrosus defects with suturing following lumbar discectomy (observation group). Perioperative, follow-up and imaging data were compared between the two groups.
Results:
No severe complications occurred in either group. The observation group had longer surgical time (67.23 ± 8.85 vs. 54.38 ± 8.16 min, P < 0.05), but no differences in incision length, blood loss, or hospital stay (P > 0.05). At 12-18-month follow-up (mean 14.3 ± 0.2 months), recurrence was observed in 6 patients (17.6 %) in the control group versus none in the observation group (P < 0.05); one recurrence required reoperation, with no intergroup difference in reoperation rates (P > 0.05). Preoperative VAS and ODI scores were comparable (P > 0.05), and both groups showed significant postoperative reductions (P < 0.05), though intergroup differences were insignificant (P > 0.05). Pfirrmann grading improved significantly in both groups postoperatively (P < 0.05) but did not differ between groups (P > 0.05). Full-endoscopic posterior longitudinal ligament coverage suturing effectively repaired annular defects, reduced recurrence, and demonstrated clinical efficacy for lumbar disc herniation.
Conclusions:
Lumbar disc herniation with annulus fibrosus defects can be treated with satisfactory clinical efficacy by using full-endoscopic posterior longitudinal ligament coverage suturing in the area of the defective annulus fibrosus, which can effectively repair fibrous annulus defects and reduce the recurrence rate of LDH.
