Abstract
OBJECTIVE: To investigate the short-term effectiveness of endoscopic lumbar discectomy combined with annular suturing in treatment of lumbar disc herniation (LDH). METHODS: A retrospective analysis was performed on the clinical data of 79 patients diagnosed with single-level LDH and admitted between February 2024 and December 2024, who met the selection criteria. Of these patients, 39 underwent a combined endoscopic discectomy with annular suturing (combined group), while 40 received endoscopic discectomy alone (control group). No significant difference was found between groups ( P>0.05) in terms of gender, age, disease duration, surgical level, or baseline measurements, including preoperative visual analogue scale (VAS) scores for back and leg pain, Oswestry disability index (ODI), and intervertebral disc height. The study evaluated and compared several parameters between groups, including operation time, intraoperative blood loss, postoperative complications, VAS scores for back and leg pain, ODI, intervertebral disc height at 1, 3, 6, and 12 months postoperatively, and recurrence during follow-up. RESULTS: The combined group experienced longer operation time compared to the control group ( P<0.05). However, there was no significant difference in intraoperative blood loss between groups ( P>0.05). Postoperative complications, such as intervertebral space infection, nerve root injury, cerebrospinal fluid leakage, or deep vein thrombosis of the lower limbs, were absent in both groups. All patients were followed up for 12 months. After operation, the ODI and VAS scores for back and leg pain showed gradual improvement in both groups ( P<0.05), yet no significant difference was observed between groups at different time points ( P>0.05). Imaging follow-up indicated a reduction in intervertebral disc height postoperatively in both groups relative to preoperative measurements ( P<0.05). No significant difference in disc height between groups was noted at 1 and 3 months ( P>0.05). At 6 and 12 months, the combined group demonstrated significantly greater disc height compared to the control group ( P<0.05). During follow-up, recurrence was observed in 1 case (2.56%) of combined group and in 3 cases (7.50%) of control group, showing no significant difference in the incidence of recurrence between groups ( P>0.05). CONCLUSION: In comparison to simple lumbar discectomy, endoscopic lumbar discectomy with annular suturing for LDH not only yields comparable short-term effectiveness but also significantly mitigates the postoperative intervertebral disc height collapse, preserves spinal stability, and decelerates the progression of disc degeneration.