Pediatric lumbar spine MRI: structural imaging findings and anatomical variants associated with disc herniation.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declarations. Competing interests: The authors declare no competing interests. 20. Medicine (Baltimore). 2019 May;98(19):e15569. doi: 10.1097/MD.0000000000015569. Small incision discectomy for lumbar disc herniation in 98 patients with 5-year follow-up: A retrospective case series study. Ren Z(1)(2), Li Z(1), Li S(1), Xu D(1), Chen X(1). Author information: (1)Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District, Beijing. (2)Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. Optimal surgical technique to treat lumbar disc herniation (LDH) remains controversial. We described a small incision discectomy technique (SID), and to evaluate its safety and efficacy. A retrospective study involving 98 consecutive patients with LDH managed by SID was conducted. All patients were followed up for 5 years. Outcomes included visual analogue scale (VAS), Japanese Orthopedic Association (JOA), operative time, length of incision, blood loss, hospital stay, hospitalization costs, x-ray exposure, reoperation, and complications. The results were determined to be excellent, good, fair, or poor according to the MacNab classification. All patients completed the 5-year follow-up. Relative to preoperative scores, VAS and JOA were both significantly improved. As a whole, 93.8% (92/98) patients showed excellent or good results, 3.1% (3/98) fair, and 3.1% (92/98) poor. The operation time, length of incision, blood loss, and hospital stay were 50 ± 11.1 minutes, 2.2 ± 0.3 cm, 35 ± 3.5 mL, and 4.3 ± 0.2 days, respectively. Additionally, compared with previous literature reports, the hospitalization costs and x-ray exposure were apparently less. The reoperation and recurrence rate were 3.2% and 2.1%. No complications were observed. From these data we conclude that SID appears to be a safe, cost-effective technique for LDH, and has lower x-rays exposure time when compared with literature of percutaneous endoscopic lumbar discectomy (PELD). DOI: 10.1097/MD.0000000000015569 PMCID: PMC6531178