脊椎ジャーナル

Percutaneous Endoscopic Lumbar Discectomy for Athletes

Abstract

Koichi Sairyo, Tetsuya Matsuura, Kosaku Higashino, Toshinori Sakai, Naoto Suzue, Daisuke Hamada,Tomohiro Goto, Yoichiro Akata, Toshihiko Nishisho, Yuichiro Goda, Ryosuke Sato, Ichiro Tonogai, Fumitake Tezuka, Kazuaki Mineta and Akira Dezawa

Study design: Retrospective review of multiple cases.

Objectives: To understand the effectiveness of Percutaneous Endoscopic Discectomy (PED) for athletes. Summary of background data: PED was first performed in 2002 and showed good clinical outcome for normal subjects. However, there are few reports for athletes.

Methods: Ten male athletes with herniated nucleus pulposus underwent PED surgery under local anesthesia. Operation time, blood loss, and surgery-related complications were recorded. Changes in Visual Analog Scale (VAS) scores for low back pain and leg pain before and after surgery were reviewed. Time to return to play (RTP), RTP rate, and recurrence were also evaluated.

Results: Herniated fragments were successfully removed endoscopically. Mean operation time was 53.5 min, blood loss during operation was negligible, and no surgery-related complications such as dural tear, nerve root injury, hematoma, or surgical site infection were observed. Subjects returned to their sport 6 to 8 weeks after surgery. The mean VAS score (out of 10) for low back and leg pain was 0.5 and 0, respectively at the final follow-up, compared with 6.5 and 4.5 before surgery. Of the patients, 9 (90%) had complete RTP, and one (10%) showed recurrence.

Conclusions: The minimal invasiveness and good clinical outcome of PED favor it as a gold standard for disc surgery in athletes.