Treatment of Calcified Lumbar Disc Herniation by Intervertebral Foramen Remolding a Retrospective Study

Ao-lin Yuan,1 Xin Shen,2 Bin Chen1 1Minimally Invasive Spine Surgery, Chengde Medical University Affiliated Hospital, Chengde, Hebei Province, People’s Republic of China; 2Breast and Thyroid Surgical Oncology, Hebei Medical University Second Affiliated Hospital, Shijiazhuang, Hebei Province, People’s Republic of ChinaCorrespondence: Bin Chen, Minimally Invasive Spine Surgery, Chengde Medical University Affiliated Hospital, Chengde, Hebei Province, People’s Republic of China, Email drchenbin@vip.sina.comPurpose: This study aimed to investigate the use of the percutaneous intervertebral foramen lens technology for secondary molding of the intervertebral foramen in the treatment of calcified lumbar discs.Methods: The study included 104 patients who were divided into two groups. Group A comprised 50 patients with calcified lumbar disc herniation and group B comprised 54 patients with non-calcified lumbar disc herniation diagnosed by computed tomography and magnetic resonance imaging. Patients underwent a percutaneous endoscopic lumbar discectomy at our hospital from January 1, 2017, to December 31, 2019. Demographic characteristics before the surgery and perioperative outcomes were retrospectively reviewed. The treatment outcome was analyzed using the numerical rating scale (NRS) score, Oswestry Disability Index (ODI) score, and modified Macnab criteria.Results: Patients in groups A and B showed significant improvement in both the NRS and ODI scores after the surgery and maintained relatively low ODI and NRS scores during subsequent follow-ups. According to the evaluation under the modified MacNab standard, the good–excellent rate of clinical efficacy was 94% in group A and 92.6% in group B at the 3 month follow-up. In group A, one patient developed neck pain during the surgery, which was diagnosed as spinal hypertension syndrome, and the surgery was suspended until the patient’s condition improved. No similar complications occurred in group B. In both the groups, no patient reported any dural leak, infection, or other related complications.Conclusion: The use of transforaminal remolding technology can significantly improve the symptoms and dysfunction of patients with calcified and non calcified lumbar disc herniation. There are few intraoperative and postoperative complications and have little impact on vertebral stability. It can provide a reference for the treatment of special types of lumbar disc herniation.Keywords: lumbar disc herniation, calcification, percutaneous transforaminal endoscopic surgery, nerve root compression, visual analog scale, Oswestry, disability index, Macnab criteria