Full-endoscopic posterior longitudinal ligament coverage suturing for lumbar disc herniation with annular defects.

BackgroundTo investigate the clinical efficacy of full-endoscopic posterior longitudinal ligament (PLL) coverage suturing in the area of the defective annulus fibrosus for the treatment of lumbar disc herniation (LDH).MethodsRetrospective analysis of patients who underwent full-endoscopic surgery for LDH in our hospital from March 2018 to July 2023, there were 56 cases presented with partial defects of the annulus fibrosus detected microscopically. Among these, 34 cases were treated with full-endoscopic lumbar discectomy alone (control group), whereas 22 cases were treated with posterior longitudinal ligament coverage of annulus fibrosus defects with suturing following lumbar discectomy (observation group). Perioperative, follow-up and imaging data were compared between the two groups.ResultsNo severe complications occurred in either group. The observation group had longer surgical time (67.23 ± 8.85 vs. 54.38 ± 8.16 min, P P > 0.05). At 12-18-month follow-up (mean 14.3 ± 0.2 months), recurrence was observed in 6 patients (17.6 %) in the control group versus none in the observation group (P P > 0.05). Preoperative VAS and ODI scores were comparable (P > 0.05), and both groups showed significant postoperative reductions (P P > 0.05). Pfirrmann grading improved significantly in both groups postoperatively (P P > 0.05). Full-endoscopic posterior longitudinal ligament coverage suturing effectively repaired annular defects, reduced recurrence, and demonstrated clinical efficacy for lumbar disc herniation.ConclusionsLumbar disc herniation with annulus fibrosus defects can be treated with satisfactory clinical efficacy by using full-endoscopic posterior longitudinal ligament coverage suturing in the area of the defective annulus fibrosus, which can effectively repair fibrous annulus defects and reduce the recurrence rate of LDH.