Early outcomes of transforaminal percutaneous endoscopic lumbar discectomy for high school athletes with herniated nucleus pulposus of the lumbar spine

Abstract Objective: To investigate the relationship between Modic changes (MCs) and recurrent lumbar disc herniation (rLDH), and that between the herniated disc component and rLDH following percutaneous endoscopic lumbar discectomy (PELD). Methods: We included 102 (65 males, 37 females, aged 20–66 yrs) inpatients who underwent PELD from August 2013 to August 2016. All patients underwent CT and MRI preoperatively. The presence and type of Modic changes were assessed. During surgery the herniated disc component of each patient was classified into two groups: nucleus pulposus group, hyaline cartilage group. The association of herniated disc component with Modic changes was investigated. The incidence of recurrent disc herniation was assessed based on more than 2-year follow-up. Results: In total, 11 patients were lost to follow up; the other 91 were followed up during 24–60 months. Of the 91 patients, 99 discs underwent PELD; 28/99 (28.3%) had MCs. Type I and II MCs were seen in 9 (9.1%) and 19 (19.2%), respectively; no type III MCs were found. Among 28 endplates with MCs, according to the herniated disc component, 18/28 (64.3%) showed evidence of hyaline cartilage in the intraoperative specimens, including 6/9 and 12/19 endplates with type I and II MCs, respectively. Among 71 endplates without MCs, 14/71 (19.7%) showed evidence of hyaline cartilage in the intraoperative specimens. Hyaline cartilage was more common in patients with MCs (P<0.05). We found 2 cases of rLDH in the non-MC group (n=71); 6 cases rLDH were found in the MC group (n=28), including 2 and 4 cases for types I and II, respectively. There was no significant difference between types I and II (P>0.05). rLDH was more common in patients with MCs (P<0.05). We found 5 rLDH cases in the hyaline cartilage group (n=32); 3 rLDH cases were found in the nucleus pulposus group (n=67). rLDH was more common in the hyaline cartilage group (P<0.05). Conclusions: MCs were associated with the herniated cartilage disc component. rLDH following PELD preferentially occurs when MCs or the herniated cartilage are present. Patients with MCs following PELD might require a second operation.

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Full Endoscopic Lumbar Discectomy using the Calcification Floating Technique for Symptomatic Partially Calcified Lumbar Herniated Nucleus Pulposus

World Neurosurgery ◽

10.1016/j.wneu.2018.06.133 ◽

2018 ◽

Vol 119 ◽

pp. 500-505 ◽

Cited By ~ 5

Author(s):

Hyeun Sung Kim ◽

Nitin Adsul ◽

Yoon Seok Ju ◽

Ki Joon Kim ◽

Sung Ho Choi ◽

...

Keyword(s):

Nucleus Pulposus ◽

Lumbar Discectomy ◽

Endoscopic Lumbar Discectomy ◽

Herniated Nucleus Pulposus

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Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present

10.21203/rs.2.19552/v1 ◽

2019 ◽

Author(s):

Lu Hao ◽

Shengwen Li ◽

Junhui Liu ◽

Zhi Shan ◽

Shunwu Fan ◽

...

Keyword(s):

Nucleus Pulposus ◽

Disc Herniation ◽

Hyaline Cartilage ◽

Modic Changes ◽

Lumbar Discectomy ◽

Herniated Disc ◽

Type I ◽

Percutaneous Endoscopic Lumbar Discectomy ◽

Recurrent Disc Herniation ◽

Endoscopic Lumbar Discectomy

Abstract Objective: To investigate the effect of Modic changes (MCs) and the herniated disc component on recurrent lumbar disc herniation (rLDH) following percutaneous endoscopic lumbar discectomy (PELD).Methods: We included 102 (65 males,37 females, aged 20–66 yr) inpatients who underwent PELD from August 2013 to August 2016. All patients underwent CT and MRI preoperative. The presence and type of Modic changes were assessed. During surgery the herniated disc component of each patient was classified into two groups: Nucleus pulposus group, Hyaline cartilage group. The association of herniated disc component with Modic changes was investigated. The incidence of recurrent disc herniation was assessed on more than 2-year follow-up.Results: In total, 11 patients were lost to follow up; the other 91 were followed up for 24–60 months. Of the 91 patients, 99 discs underwent PELD; 28/99 (28.3%) had MCs. Type I and II MCs were seen in 9 (9.1%) and 19 (19.2%), respectively; no type III MCs were found. Among 28 endplates with MCs, according to the herniated disc component, 18/28 (64.3%) showed evidence of hyaline cartilage in the intraoperative specimens, including 6/9 and 12/19 endplates with type I and II MCs, respectively. Among 71 endplates without MCs, 14/71 (19.7%) showed evidence of hyaline cartilage in the intraoperative specimens. Hyaline cartilage was more common in patients with MCs (P<0.05). We found 2 cases of rLDH in the non-MC group (n=71); 6 cases rLDH were found in the MC group (n=28), including 2 and 4 cases for types I and II, respectively. There was no significant difference between types I and II (P>0.05). rLDH was more common in patients with MCs (P<0.05). We found 5 rLDH cases in the hyaline cartilage group (n=32); 3 rLDH cases were found in the nucleus pulposus group (n=67). rLDH was more common in the hyaline cartilage group (P<0.05). Conclusions: MCs were associated with the herniated cartilage disc component. rLDH following PELD preferentially occurs when MCs or the herniated cartilage are present.

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Recurrent disc herniation following percutaneous endoscopic lumbar discectomy preferentially occurs when Modic changes are present

10.21203/rs.2.19552/v3 ◽

2020 ◽

Author(s):

Lu Hao ◽

Shengwen Li ◽

Junhui Liu ◽

Zhi Shan ◽

Shunwu Fan ◽

...

Keyword(s):

Nucleus Pulposus ◽

Disc Herniation ◽

Hyaline Cartilage ◽

Modic Changes ◽

Lumbar Discectomy ◽

Herniated Disc ◽

Type I ◽

Percutaneous Endoscopic Lumbar Discectomy ◽

Endoscopic Lumbar Discectomy

Abstract Objective: To investigate the relationship between Modic changes (MCs) and recurrent lumbar disc herniation (rLDH), and that between the herniated disc component and rLDH following percutaneous endoscopic lumbar discectomy (PELD). Methods: We included 102 (65 males, 37 females, aged 20–66 yrs) inpatients who underwent PELD from August 2013 to August 2016. All patients underwent CT and MRI preoperatively. The presence and type of Modic changes were assessed. During surgery the herniated disc component of each patient was classified into two groups: nucleus pulposus group, hyaline cartilage group. The association of herniated disc component with Modic changes was investigated. The incidence of rLDH was assessed based on more than 2-year follow-up. Results: In total, 11 patients were lost to follow up; the other 91 were followed up during 24–60 months. Of the 91 patients, 99 discs underwent PELD; 28/99 (28.3%) had MCs. Type I and II MCs were seen in 9 (9.1%) and 19 (19.2%), respectively; no type III MCs were found. Among 28 endplates with MCs, according to the herniated disc component, 18/28 (64.3%) showed evidence of hyaline cartilage in the intraoperative specimens, including 6/9 and 12/19 endplates with type I and II MCs, respectively. Among 71 endplates without MCs, 14/71 (19.7%) showed evidence of hyaline cartilage in the intraoperative specimens. Hyaline cartilage was more common in patients with MCs (P<0.05). We found 2 cases of rLDH in the non-MC group (n=71); 6 cases rLDH were found in the MC group (n=28), including 2 and 4 cases for types I and II, respectively. There was no significant difference between types I and II (P>0.05). rLDH was more common in patients with MCs (P<0.05). We found 5 rLDH cases in the hyaline cartilage group (n=32); 3 rLDH cases were found in the nucleus pulposus group (n=67). rLDH was more common in the hyaline cartilage group (P<0.05). Conclusions: rLDH following PELD preferentially occurs when MCs or herniated cartilage are present.

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