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| LIU Ran,CHEN Dan,QI Yingzhao.Efficacy of spinal endoscopic surgery combined with platelet-rich plasma in the treatment of far lateral lumbar disc herniation[J].Chinese Journal of Spine and Spinal Cord,2026,(4):422-429. |
| Efficacy of spinal endoscopic surgery combined with platelet-rich plasma in the treatment of far lateral lumbar disc herniation |
| Received:July 05, 2025 Revised:November 02, 2025 |
| English Keywords:Far lateral lumber disc herniation Spinal endoscopy Platelet-rich plasma(PRP) Neuropathic pain |
| Fund:河北省省级科技计划资助项目（246Z2001G）；秦皇岛市科技计划项目（202101A121） |
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| English Abstract: |
| 【Abstract】 Objectives: To evaluate the early-to-midterm clinical outcomes of single-portal transforaminal endoscopic lumbar discectomy(TELD) combined with platelet-rich plasma(PRP) in the treatment of far lateral lumbar disc herniation(FLLDH). Methods: A retrospective analysis was conducted on 74 FLLDH patients who underwent TELD at the Department of Spinal Surgery, between May 2020 and December 2024. Among them, 32 patients underwent TELD followed by an injection of autologous PRP around the exiting nerve root upon completion of decompression(PRP group), which consisted of 13 male cases and 19 female cases, with an average age of 65.96±14.05 years; while 42 patients received TELD alone(control group), and there were 11 male cases and 31 female cases, with an average age of 58.84±16.15 years. Propensity score matching(PSM) was performed using four covariates(gender, age, BMI, disease duration) in a 1∶1 ratio, resulting in 24 matched patients per group. Outcomes assessed preoperatively and at 3d, 1 week, 6 weeks, 3 months, and 6 months postoperatively included visual analog scale(VAS) scores for low back and leg pain and Oswestry disability index(ODI). Lumbar stability was evaluated using flexion-extension X-rays at the 3-month follow-up. Treatment efficacy was rated using the modified MacNab criteria at the 6-month follow-up. Results: Both groups showed significant improvement in VAS scores and ODI compared to preoperative baselines(P<0.05). The PRP group exhibited significantly lower VAS scores and ODI indices than the control group at postoperative 3d, 1 week, and 6 weeks, with a statistically significant difference between groups(P<0.05). However, no significant differences were observed between the two groups at postoperative 3 months or 6 months(P>0.05). Lumbar stability assessed by flexion-extension X-rays at 3 months remained unchanged compared to preoperative status, with no significant difference between groups(P>0.05). At 6 months, the excellent and good rates according to the modified MacNab criteria were 87.5% in the PRP group and 83.3% in the control group, with no statistically significant difference between groups(P>0.05). Conclusions: TELD is a safe and effective surgical approach for the treatment of FLLDH. Comparing to TELD alone, TELD combined with PRP can promote faster recoveries from radicular pain and functional impairment in patients with FLLDH in the early postoperative period(≤6 weeks), while the efficacy is comparable to TELD alone in the mid-term(3-6 months). |
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