Percutaneous transforaminal endoscopic discectomy combined with platelet-rich plasma in treatment of lumbar disc herniation / 中国组织工程研究

ABSTRACT

BACKGROUND:Platelet-rich plasma can promote the repair and regeneration of intervertebral disc tissue.Percutaneous transforaminal endoscopic discectomy is widely used in the treatment of lumbar disc herniation.In recent years,more and more scholars have focused on the combined treatment of lumbar disc herniation with the two techniques in order to achieve a better patient prognosis. OBJECTIVE:To investigate the clinical safety and effectiveness of percutaneous transforaminal endoscopic discectomy combined with platelet-rich plasma in the treatment of lumbar disc herniation. METHODS:The clinical data of 58 patients with lumbar disc herniation who met the inclusion and exclusion criteria at Sixth Medical Center of PLA General Hospital from June 2017 to May 2018 were retrospectively analyzed.Among them,29 patients underwent percutaneous transforaminal endoscopic discectomy combined with platelet-rich plasma(observation group),and the remaining 29 patients underwent percutaneous transforaminal endoscopic discectomy only(control group).Visual Analogue Scale score for back and leg pain,lumbar JOA score,and Oswestry Disability Index were evaluated preoperatively,at 3,6,and 12 months postoperatively,and at the last follow-up.Intervertebral space height,nucleus pulposus to cerebrospinal fluid signal strength ratio,and intervertebral disc Pfirrmann grading were measured preoperatively,at 6 and 12 months postoperatively,and at the last follow-up.The modified MacNab criteria were used to assess excellent and good rate of curative effect at the last follow-up. RESULTS AND CONCLUSION:(1)The Visual Analogue Scale score for back and leg pain,JOA score,and Oswestry Disability Index of the two groups postoperatively were significantly improved compared with those preoperatively(P<0.05).Visual Analogue Scale score and Oswestry Disability Index were lower in the observation group than those in the control group at 3 and 6 months postoperatively(P<0.05).The JOA score was higher in the observation group than that in the control group at 3 and 6 months postoperatively(P<0.05).(2)The nucleus pulposus to cerebrospinal fluid signal strength ratio was higher in the observation group than that in the control group at the last follow-up(P<0.05).Pfirrmann grading of the intervertebral discs was better in the observation group than that in the control group(P<0.05).The excellent and good rate was 93%in the observation group and 83%in the control group,and the difference was not statistically significant(P>0.05).(3)These findings indicate that percutaneous transforaminal endoscopic discectomy combined with platelet-rich plasma in the treatment of lumbar disc herniation has satisfactory clinical efficacy and can delay the degeneration of the intervertebral disc to a certain extent.