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The clinical application of "jetting suture" technique in annular repair under microendoscopic discectomy: A prospective single-cohort observational study.

Qi L, Li M, Si H, Wang L, Jiang Y, Zhang S, Li L - Medicine (Baltimore) (2016)

Bottom Line: The preoperative symptoms were alleviated significantly after surgery.All the standardized measures improved significantly at the last follow-up, including JOA score (10.1 to 26.6; P < 0.05) and Oswestry Disability Index (75.3 to 9.6; P < 0.05).Approximately 83.4% of patients reported good or excellent outcomes based on modified Mcnab criteria.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Qilu Hospital, Shandong University, No.107, Wenhua Xi Road, Jinan, Shandong, China.

ABSTRACT
To introduce a new designed suture technique in annular repair under the microendoscopic discectomy (MED) surgery and to evaluate the clinical application of the technique in annular repair under MED with at least 2-year follow-up period.A new method of annular repair was designed and named "jetting suture" technique. Thirty consecutive patients with lumbar disc herniation were enrolled in the prospective single-cohort observational study. Patients were followed up at intervals of preoperative, postoperative 1 week, 3 months, 6 months, 1 year, and last follow-up. The clinical outcomes were evaluated by using Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index, and modified Mcnab criteria.The procedure was successfully performed in all cases. No case required conversion to an open procedure. The mean age of patients was 36.6 years. Average blood loss was 45.8 ± 10.2 mL. The preoperative symptoms were alleviated significantly after surgery. All the standardized measures improved significantly at the last follow-up, including JOA score (10.1 to 26.6; P < 0.05) and Oswestry Disability Index (75.3 to 9.6; P < 0.05). Improvement rate of JOA score was 86.4%. Approximately 83.4% of patients reported good or excellent outcomes based on modified Mcnab criteria. No postoperative complication and recurrence of disc herniation was reported.The designed "jetting suture" technique in annular repair under MED can be performed safely and effectively. It could be a viable alternative to annular repair under lumbar discectomy.

No MeSH data available.


Related in: MedlinePlus

The schematic diagrams (A–H) of annular suture after the microendoscopic discectomy.
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Figure 2: The schematic diagrams (A–H) of annular suture after the microendoscopic discectomy.

Mentions: After that, the needle point of prepared injector was inserted into the residual space of removed disc at the depth of 2 cm through the normal annulus at one side of the incision. The suture in the syringe was then partly pushed into the residual cavity of disc through the needle by jetting the saline in the syringe. We called the process “jetting suture” technique. The suture was pulled out from the annulus incision using pulposus clamp. Then, another suture was also injected from another side of annulus incision and pulled out. The ends of 2 sutures which were pulled out from the annulus incision were knotted. Then, by pulling either end of the other 2 ends, the last suture could cross the annulus incision through the normal annulus. After that, the suture was tightened and knotted outside the annulus, and the annulus incision was closed. The retractors were then removed and incision was closed in layers. The schematic diagrams and endoscopic photos of annular suture were respectively shown in Fig. 2 and Fig. 3.


The clinical application of "jetting suture" technique in annular repair under microendoscopic discectomy: A prospective single-cohort observational study.

Qi L, Li M, Si H, Wang L, Jiang Y, Zhang S, Li L - Medicine (Baltimore) (2016)

The schematic diagrams (A–H) of annular suture after the microendoscopic discectomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979855&req=5

Figure 2: The schematic diagrams (A–H) of annular suture after the microendoscopic discectomy.
Mentions: After that, the needle point of prepared injector was inserted into the residual space of removed disc at the depth of 2 cm through the normal annulus at one side of the incision. The suture in the syringe was then partly pushed into the residual cavity of disc through the needle by jetting the saline in the syringe. We called the process “jetting suture” technique. The suture was pulled out from the annulus incision using pulposus clamp. Then, another suture was also injected from another side of annulus incision and pulled out. The ends of 2 sutures which were pulled out from the annulus incision were knotted. Then, by pulling either end of the other 2 ends, the last suture could cross the annulus incision through the normal annulus. After that, the suture was tightened and knotted outside the annulus, and the annulus incision was closed. The retractors were then removed and incision was closed in layers. The schematic diagrams and endoscopic photos of annular suture were respectively shown in Fig. 2 and Fig. 3.

Bottom Line: The preoperative symptoms were alleviated significantly after surgery.All the standardized measures improved significantly at the last follow-up, including JOA score (10.1 to 26.6; P < 0.05) and Oswestry Disability Index (75.3 to 9.6; P < 0.05).Approximately 83.4% of patients reported good or excellent outcomes based on modified Mcnab criteria.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Qilu Hospital, Shandong University, No.107, Wenhua Xi Road, Jinan, Shandong, China.

ABSTRACT
To introduce a new designed suture technique in annular repair under the microendoscopic discectomy (MED) surgery and to evaluate the clinical application of the technique in annular repair under MED with at least 2-year follow-up period.A new method of annular repair was designed and named "jetting suture" technique. Thirty consecutive patients with lumbar disc herniation were enrolled in the prospective single-cohort observational study. Patients were followed up at intervals of preoperative, postoperative 1 week, 3 months, 6 months, 1 year, and last follow-up. The clinical outcomes were evaluated by using Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index, and modified Mcnab criteria.The procedure was successfully performed in all cases. No case required conversion to an open procedure. The mean age of patients was 36.6 years. Average blood loss was 45.8 ± 10.2 mL. The preoperative symptoms were alleviated significantly after surgery. All the standardized measures improved significantly at the last follow-up, including JOA score (10.1 to 26.6; P < 0.05) and Oswestry Disability Index (75.3 to 9.6; P < 0.05). Improvement rate of JOA score was 86.4%. Approximately 83.4% of patients reported good or excellent outcomes based on modified Mcnab criteria. No postoperative complication and recurrence of disc herniation was reported.The designed "jetting suture" technique in annular repair under MED can be performed safely and effectively. It could be a viable alternative to annular repair under lumbar discectomy.

No MeSH data available.


Related in: MedlinePlus