Clinical Study of Ultrasound-Guided Modified Percutaneous Endoscopic Interlaminar Discectomy Combined With Medical Chitosan in Lumbar 4-5 Disc Herniation Treatment.

Résumé de l'étude

200 patients with lumbar disc herniation (LDH) at the L4–L5 level were randomized to receive ultrasound-guided modified percutaneous endoscopic interlaminar discectomy (PEID) combined with medical chitosan (n = 100) or ultrasound-guided PEID alone (n = 100). Treatment efficacy was assessed using the modified MacNab criteria, while other outcomes included pain intensity measured using the Visual Analogue Scale (VAS), lumbar function assessed using the Japanese Orthopaedic Association (JOA) score, functional disability measured using the Oswestry Disability Index (ODI), and surgical complications. Pain and functional outcomes were assessed at 2 weeks and 1, 3, and 6 months postoperatively, while clinical efficacy was evaluated at 1 year. Overall, the results revealed that adding medical chitosan significantly improved early postoperative pain and function, increased treatment efficacy at 1 year, and reduced surgical complications compared with PEID alone. These findings suggested that medical chitosan could be a beneficial adjunct to ultrasound-guided PEID for improving postoperative recovery and clinical outcomes in patients with L4–L5 LDH.