Transforaminal Percutaneous Endoscopic Discectomy in the Treatment of Adolescent Lumbar Disc Herniations With Posterior Ring Apophysis Separation

Objective: To assess the efficacy of transforaminal percutaneous endoscopic discectomy in the treatment of adolescent lumbar disc herniations with posterior ring apophysis separation Methods: Overall 23 cases of adolescent lumbar disc herniations with posterior ring apophysis separation were treated with the procedure of transforaminal percutaneous endoscopic discectomy between January 2016 and December 2019. Preoperative and postoperative (6 week, 6 month and 12 month) clinical outcome data (back and leg VAS and Macnab criteria) were collected along with clinical assessments of motor strength (graded 0-5). Results: All patients were discharged to home on the same day of surgery. The average leg Visual Analog Scale improved from 8.7 ± 1.5 to 2.0± 0.5 (p < 0.005). Fifteen patients had excellent outcomes, six had good outcomes, two had fair outcomes, and no had poor outcomes, according to the Macnab criteria. Ten of eleven patients had excellent or good outcomes, for an overall success rate of 91.3%. No patients required reoperation. There were no incidental durotomies, infections, vascular or visceral injuries. There was 1 complication, a case of leg numbness caused by ganglion injury. The numbness improved after 3 weeks. After 2 months, it was obvious that the total area of numbness in the legs had become smaller. At last follow-up, the patient had no pain, and only a few areas with numbness remained and did not affect the patient’s activities of daily living. Conclusion: Transforaminal percutaneous endoscopic discectomy achieve satisfactory results for adolescent lumbar disc herniations with posterior ring apophysis separation.