Classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on CT three-dimensional reconstruction and its clinical significance

Abstract Objective To propose a new classification method based on CT three-dimensional reconstruction for inferior articular process injury following percutaneous endoscopic interlaminar lumbar discectomy (PEID), and to analyze the impact of > 50% inferior articular process(IAP) defect on clinic...

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Main Authors: Haigang Hu, Chao Wu, Tao Li, Hong Li
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-025-09004-0
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author Haigang Hu
Chao Wu
Tao Li
Hong Li
author_facet Haigang Hu
Chao Wu
Tao Li
Hong Li
author_sort Haigang Hu
collection DOAJ
description Abstract Objective To propose a new classification method based on CT three-dimensional reconstruction for inferior articular process injury following percutaneous endoscopic interlaminar lumbar discectomy (PEID), and to analyze the impact of > 50% inferior articular process(IAP) defect on clinical outcomes. Methods A retrospective analysis was conducted on 100 PEID patients. IAP injuries were classified into four types based on CT three-dimensional reconstruction, and the inter- and intra-observer reliability was assessed using the Kappa consistency test. Patients were divided into two groups based on IAP defect size: Group A (defect ≤ 50%) and Group B (defect > 50%). VAS, ODI, clinical outcomes, and lumbar instability were compared between the two groups, and IAP changes were observed. Results The classification showed good inter- and intra-observer consistency. There were no significant differences in VAS, ODI, clinical outcomes, or lumbar instability between the two groups (P > 0.05). Both groups showed varying degrees of IAP regeneration and remodeling. Conclusion The classification of IAP injuries based on CT three-dimensional reconstruction demonstrates good inter- and intra-observer consistency. In the short term, patients with > 50% IAP defects (Types III and IV) show no difference in lumbar stability or clinical outcomes compared to those with ≤ 50% defects (Types I and II).However, for patients with complete IAP loss (Type IV), the potential long-term risk of lumbar instability and related clinical complications remains a concern.
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spelling doaj-art-839c8dcec7d04772a8d25635745b3b902025-08-20T03:42:37ZengBMCBMC Musculoskeletal Disorders1471-24742025-07-012611910.1186/s12891-025-09004-0Classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on CT three-dimensional reconstruction and its clinical significanceHaigang Hu0Chao Wu1Tao Li2Hong Li3Department of Spine Surgery and Traumatology Surgery, Zigong Fourth People’s HospitalDepartment of Spine Surgery and Traumatology Surgery, Zigong Fourth People’s HospitalDepartment of Spine Surgery and Traumatology Surgery, Zigong Fourth People’s HospitalDepartment of Spine Surgery and Traumatology Surgery, Zigong Fourth People’s HospitalAbstract Objective To propose a new classification method based on CT three-dimensional reconstruction for inferior articular process injury following percutaneous endoscopic interlaminar lumbar discectomy (PEID), and to analyze the impact of > 50% inferior articular process(IAP) defect on clinical outcomes. Methods A retrospective analysis was conducted on 100 PEID patients. IAP injuries were classified into four types based on CT three-dimensional reconstruction, and the inter- and intra-observer reliability was assessed using the Kappa consistency test. Patients were divided into two groups based on IAP defect size: Group A (defect ≤ 50%) and Group B (defect > 50%). VAS, ODI, clinical outcomes, and lumbar instability were compared between the two groups, and IAP changes were observed. Results The classification showed good inter- and intra-observer consistency. There were no significant differences in VAS, ODI, clinical outcomes, or lumbar instability between the two groups (P > 0.05). Both groups showed varying degrees of IAP regeneration and remodeling. Conclusion The classification of IAP injuries based on CT three-dimensional reconstruction demonstrates good inter- and intra-observer consistency. In the short term, patients with > 50% IAP defects (Types III and IV) show no difference in lumbar stability or clinical outcomes compared to those with ≤ 50% defects (Types I and II).However, for patients with complete IAP loss (Type IV), the potential long-term risk of lumbar instability and related clinical complications remains a concern.https://doi.org/10.1186/s12891-025-09004-0Interlaminar approachInferior articular process injuryLumbar instabilityCT three-dimensional reconstructionClassification
spellingShingle Haigang Hu
Chao Wu
Tao Li
Hong Li
Classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on CT three-dimensional reconstruction and its clinical significance
BMC Musculoskeletal Disorders
Interlaminar approach
Inferior articular process injury
Lumbar instability
CT three-dimensional reconstruction
Classification
title Classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on CT three-dimensional reconstruction and its clinical significance
title_full Classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on CT three-dimensional reconstruction and its clinical significance
title_fullStr Classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on CT three-dimensional reconstruction and its clinical significance
title_full_unstemmed Classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on CT three-dimensional reconstruction and its clinical significance
title_short Classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on CT three-dimensional reconstruction and its clinical significance
title_sort classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on ct three dimensional reconstruction and its clinical significance
topic Interlaminar approach
Inferior articular process injury
Lumbar instability
CT three-dimensional reconstruction
Classification
url https://doi.org/10.1186/s12891-025-09004-0
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