Safety and efficacy of arthroscopic-assisted uni-portal spinal surgery combined with bone anchoring annulus fibrosus suture technique for treatment of lumbar disc herniation with vertebral edge annulus fibrosus tear

Abstract Objective: To investigate the safety and clinical effectiveness of Arthroscopic-assisted Uni-portal Spinal Surgery(AUSS)combined with bone anchoringannulus fibrosus suture technique in the treatment of lumbar disc herniation(LDH) with vertebral edge annulus fibrosus tear. Methods: A total of 52 patients with LDH with vertebral edge annulus fibrosus tear from March 2019 to March 2023 in our hospital were included in this study.All patients were treated by AUSS combined with bone anchoring annulus fibrosus suture technique.The visual analog scale (VAS) score for lower back and lower limb pain and the oswestry disability index (ODI) were used to compare before operation and 1 month, 6 months and 12 months after operation. The clinical efficacy was evaluated by modified MacNab efficacy standard at 12 months after operation. Results: All patients completed the operation successfully and obtained follow-up results, the average follow-up time was 13.8 months (range, 12-18 months).The average operation time was 105 minutes (range, 68-143 minutes).There were 2 cases of dural sac tear during operation,one patient had aggravation of pain and numbness in the ipsilateral lower limb and hypoesthesia in the perineal region after operation,one patient developed postoperative incision infection.The incidence of complications was 7.69%. One month after operation,the VAS scores for lower back and lower limb pain and ODI were signifcantly lower than before the operation (P<0.05).The above indicators continued to improve at 6 months and 12 months after operation, and the differences were significant (P<0.05).According to the modified MacNab efficacy standard at 12 months after operation, 41 cases were excellent, 9 cases were good, and 2 cases were acceptable, with an excellent and good rate of 96.15%. No recurrence was observed. Conclusion:AUSS combined with bone anchoring annulus fibrosus suture technique is a safe and effective surgical method for the treatment of LDH with vertebral edge annulus fibrosus tear.It can effectively reduce the recurrence rate, achieve a high excellent and good rate and good clinical efficacy ,which is worthy of clinical promotion.