Efficacy of percutaneous endoscopic lumbar discectomy (PELD) combined with sinuvertebral nerve ablation versus PELD for low back pain in lumbar disc herniation

Abstract Background Percutaneous endoscopic lumbar discectomy (PELD) has demonstrated variable efficacy in alleviating low back pain (LBP) associated with lumbar disc herniation (LDH). Sinuvertebral nerve ablation (SNA), which targets the nociceptive pathway implicated in discogenic LBP pathogenesis...

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Main Authors: Yanjun Huang, Shangshu Wei, Shuyue Yang, Yanzhu Shen, Haoning Ma, Ping Yi, Xiangsheng Tang
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-024-05269-8
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author Yanjun Huang
Shangshu Wei
Shuyue Yang
Yanzhu Shen
Haoning Ma
Ping Yi
Xiangsheng Tang
author_facet Yanjun Huang
Shangshu Wei
Shuyue Yang
Yanzhu Shen
Haoning Ma
Ping Yi
Xiangsheng Tang
author_sort Yanjun Huang
collection DOAJ
description Abstract Background Percutaneous endoscopic lumbar discectomy (PELD) has demonstrated variable efficacy in alleviating low back pain (LBP) associated with lumbar disc herniation (LDH). Sinuvertebral nerve ablation (SNA), which targets the nociceptive pathway implicated in discogenic LBP pathogenesis, has emerged as a potential adjunctive therapy. The efficacy of endoscopic radiofrequency ablation in enhancing PELD for the treatment of LBP in patients with LDH remains unclear. Methods A retrospective cohort study was conducted on LDH patients with concomitant LBP treated at the Spinal Surgery Department, China-Japan Friendship Hospital, from June 2020 to June 2023. Participants were categorized into two groups: PELD combined with SNA (n = 51) and PELD alone (n = 46). Primary outcome measures included the Visual Analog Scale (VAS) for pain, the Japanese Orthopaedic Association (JOA) score, and the Oswestry Disability Index (ODI) at baseline and 1-, 3-, and 6-month follow-ups. Results Both groups exhibited significant improvements in VAS, JOA, and ODI scores for LBP and leg pain postoperatively compared to preoperative assessments. Notably, the PELD combined with SNA group demonstrated statistically significant superior outcomes in VAS, JOA, and ODI scores specifically for LBP compared to the PELD group. Conclusion The combination of PELD with SNA significantly improves LBP outcomes compared to PELD alone in LDH patients. While the observed improvements did not reach the minimal clinically important differences (MICD), these findings suggest that SNA may enhance the efficacy of PELD in LBP management.
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spelling doaj-art-e17808c63b5e443580fc9941d6a062b82025-08-20T02:22:21ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2024-11-011911910.1186/s13018-024-05269-8Efficacy of percutaneous endoscopic lumbar discectomy (PELD) combined with sinuvertebral nerve ablation versus PELD for low back pain in lumbar disc herniationYanjun Huang0Shangshu Wei1Shuyue Yang2Yanzhu Shen3Haoning Ma4Ping Yi5Xiangsheng Tang6Chinese Academy of Medical Sciences & Peking Union Medical CollegeChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing University of Chinese MedicineChinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Orthopaedics, China-Japan Friendship HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeChinese Academy of Medical Sciences & Peking Union Medical CollegeAbstract Background Percutaneous endoscopic lumbar discectomy (PELD) has demonstrated variable efficacy in alleviating low back pain (LBP) associated with lumbar disc herniation (LDH). Sinuvertebral nerve ablation (SNA), which targets the nociceptive pathway implicated in discogenic LBP pathogenesis, has emerged as a potential adjunctive therapy. The efficacy of endoscopic radiofrequency ablation in enhancing PELD for the treatment of LBP in patients with LDH remains unclear. Methods A retrospective cohort study was conducted on LDH patients with concomitant LBP treated at the Spinal Surgery Department, China-Japan Friendship Hospital, from June 2020 to June 2023. Participants were categorized into two groups: PELD combined with SNA (n = 51) and PELD alone (n = 46). Primary outcome measures included the Visual Analog Scale (VAS) for pain, the Japanese Orthopaedic Association (JOA) score, and the Oswestry Disability Index (ODI) at baseline and 1-, 3-, and 6-month follow-ups. Results Both groups exhibited significant improvements in VAS, JOA, and ODI scores for LBP and leg pain postoperatively compared to preoperative assessments. Notably, the PELD combined with SNA group demonstrated statistically significant superior outcomes in VAS, JOA, and ODI scores specifically for LBP compared to the PELD group. Conclusion The combination of PELD with SNA significantly improves LBP outcomes compared to PELD alone in LDH patients. While the observed improvements did not reach the minimal clinically important differences (MICD), these findings suggest that SNA may enhance the efficacy of PELD in LBP management.https://doi.org/10.1186/s13018-024-05269-8Low back painSinuvertebral nerveLumbar disc herniationPercutaneous endoscopyCase series
spellingShingle Yanjun Huang
Shangshu Wei
Shuyue Yang
Yanzhu Shen
Haoning Ma
Ping Yi
Xiangsheng Tang
Efficacy of percutaneous endoscopic lumbar discectomy (PELD) combined with sinuvertebral nerve ablation versus PELD for low back pain in lumbar disc herniation
Journal of Orthopaedic Surgery and Research
Low back pain
Sinuvertebral nerve
Lumbar disc herniation
Percutaneous endoscopy
Case series
title Efficacy of percutaneous endoscopic lumbar discectomy (PELD) combined with sinuvertebral nerve ablation versus PELD for low back pain in lumbar disc herniation
title_full Efficacy of percutaneous endoscopic lumbar discectomy (PELD) combined with sinuvertebral nerve ablation versus PELD for low back pain in lumbar disc herniation
title_fullStr Efficacy of percutaneous endoscopic lumbar discectomy (PELD) combined with sinuvertebral nerve ablation versus PELD for low back pain in lumbar disc herniation
title_full_unstemmed Efficacy of percutaneous endoscopic lumbar discectomy (PELD) combined with sinuvertebral nerve ablation versus PELD for low back pain in lumbar disc herniation
title_short Efficacy of percutaneous endoscopic lumbar discectomy (PELD) combined with sinuvertebral nerve ablation versus PELD for low back pain in lumbar disc herniation
title_sort efficacy of percutaneous endoscopic lumbar discectomy peld combined with sinuvertebral nerve ablation versus peld for low back pain in lumbar disc herniation
topic Low back pain
Sinuvertebral nerve
Lumbar disc herniation
Percutaneous endoscopy
Case series
url https://doi.org/10.1186/s13018-024-05269-8
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