Endoscopic Discectomy and Annulus Suture in Recurrent Lumbar Herniation: A Retrospective Analysis

BACKGROUND There are few published clinical studies involving patients with recurrent lumbar disc protrusion. This retrospective study from a single center included 21 patients with recurrent lumbar disc herniation (LDH) to evaluate outcomes following treatment using unilateral biportal endoscopic (UBE) discectomy combined with nucleus pulposus removal combined with lumbar annulus fibrosus suture (NPR-LAFS). MATERIAL AND METHODS A retrospective analysis was performed on 21 patients with recurrent LDH treated with NPR-LAFS under UBE at Mianyang Orthopedic Hospital from May 2020 to July 2022. The perioperative parameters and follow-up results are summarized. RESULTS All surgical procedures were completed successfully. The operative times ranged from 82 to 146 min, with an average of 106.71±17.9 min. Blood loss during surgery ranged from 34 to 107 ml, averaging 72.62±21.32 ml. No complications occurred. The follow-up duration ranged from 4 to 17 months, with an average follow-up duration of 11.38±3.51 months. No disc herniation recurrences were reported. There was a significant improvement in the postoperative visual analog scale score for back and leg pain and the Oswestry Disability Index when compared to preoperative scores (P<0.05). Sixteen cases were rated as excellent, 3 as good, and 2 as fair based on the MacNab criteria for assessing treatment outcomes, which results in an excellent-to-good rate of 90.47%. CONCLUSIONS The primary clinical efficacy of NPR-LAFS under UBE for the treatment of LDH was good over 1 year, without complications or recurrences.