Orthopaedic Surgery (Aug 2020)

Percutaneous Transforaminal Endoscopic Discectomy and Fenestration Discectomy to Treat Posterior Ring Apophyseal Fractures: A Retrospective Cohort Study

  • Yao‐bin Wang,
  • Shu‐lian Chen,
  • Chen Cao,
  • Kai Zhang,
  • Li‐min Liu,
  • Yan‐zheng Gao

DOI
https://doi.org/10.1111/os.12698
Journal volume & issue
Vol. 12, no. 4
pp. 1092 – 1099

Abstract

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Objective To compare the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) for posterior ring apophyseal fractures (PRAF). Methods This study was a retrospective cohort control study. A total of 96 patients with lumbar PRAF who underwent surgical treatment at the Henan Provincial People's Hospital of Henan University from September 2013 to December 2017 were retrospectively examined, of which 51 were treated by PTED and 45 by FD. The average age of those in the PTED group was 28.24 years, including 38 males and 13 females. The average age of those in the FD group was 28.07 years, with 33 males and 12 females. Operation time, total blood loss, hospitalization days, preoperative and postoperative visual analog scale (VAS), and Oswestry disability index (ODI) scores were evaluated. Modified MacNab criteria were used to evaluate the clinical effect at the last follow‐up. Results Both operations were successful and no serious complications occurred. All patients were followed up for 12–30 (average 16.7 ± 3.2) months, and no patients were lost to follow‐up. No statistically significant difference was found in the mean age and gender between the PTED group and the FD group (P 0.05). In the PTED group, 2 patients developed a transient nerve stimulation symptom within 1 day after surgery and 1 patient had recurrence at 3 months after surgery. In the FD group, 2 patients had severe dural ruptures due to adhesion during surgery, 1 patient developed infection complications, and 2 patients relapsed at 2 and 3 months after surgery. At the last follow‐up, the modified MacNab criteria for clinical effect were 93.3% and 94.1% in the FD and PTED groups, respectively. Conclusion While PTED has the same efficacy as FD for treating PRAF, it is associated with shorter operation time, less trauma, and quicker recovery.

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