Full-endoscopic posterior longitudinal ligament coverage suturing for lumbar disc herniation with annular defects

Area of Science:

• Minimally Invasive Spine Surgery
• Spinal Anatomy and Biomechanics
• Degenerative Disc Disease

Background:

• Lumbar disc herniation (LDH) can involve defects in the annulus fibrosus.
• Traditional treatments may not always address annular defects effectively.
• Full-endoscopic techniques offer new possibilities for addressing these specific pathologies.

Purpose of the Study:

• To evaluate the clinical efficacy of full-endoscopic posterior longitudinal ligament (PLL) coverage suturing for annular defects in LDH.
• To compare outcomes between PLL suturing and standard discectomy.
• To assess the impact on recurrence rates and clinical scores.

Main Methods:

• Retrospective analysis of 56 LDH patients with annular defects.
• Comparison of 22 patients treated with PLL suturing (observation group) versus 34 with discectomy alone (control group).
• Data collected included surgical parameters, follow-up outcomes, and imaging (VAS, ODI, Pfirrmann grading).

Main Results:

• No severe complications in either group.
• Observation group had longer surgical time but similar incision length, blood loss, and hospital stay.
• Recurrence rate was 0% in the observation group versus 17.6% in the control group (P < 0.05).
• Both groups showed significant postoperative improvement in VAS and ODI scores, with no intergroup difference.

Conclusions:

• Full-endoscopic PLL coverage suturing is clinically effective for treating LDH with annular defects.
• The technique successfully repairs annular defects and significantly reduces LDH recurrence.
• This method demonstrates promising results for improving patient outcomes in specific LDH cases.