Endoscopic removal of nucleus pulposus of intervertebral disc on lumbar intervertebral disc protrusion and the influence on inflammatory factors and immune function

Gang Xu; Changchun Zhang; Kun Zhu; Zhengqi Bao; Pinghui Zhou; Xiaojun Li

doi:10.3892/etm.2019.8223

Endoscopic removal of nucleus pulposus of intervertebral disc on lumbar intervertebral disc protrusion and the influence on inflammatory factors and immune function

Exp Ther Med. 2020 Jan;19(1):301-307. doi: 10.3892/etm.2019.8223. Epub 2019 Nov 19.

Authors

Gang Xu¹, Changchun Zhang¹, Kun Zhu¹, Zhengqi Bao¹, Pinghui Zhou¹, Xiaojun Li²

Affiliations

¹ Department of Orthopedics, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China.
² Department of Spine, Wuxi Traditional Chinese Medicine Hospital, Wuxi, Jiangsu 214071, P.R. China.

Abstract

Endoscopic removal of nucleus pulposus (NP) of intervertebral disc (IVD) on lumbar intervertebral disc protrusion (LIDP) and its influence on inflammatory factors and immune function were explored. A total of 145 patients with LIDP admitted to The First Affiliated Hospital of Bengbu Medical College from June 2017 to December 2018 were selected and electively treated, in which 87 patients were treated with fenestration discectomy (fenestration group) and 58 patients were treated with endoscopic removal of NP of IVD (minimally invasive group). Effects on patients in the two groups within 6 months after surgery were evaluated by modified MacNab score; differences in surgical related indexes and incidence rates of complications between the two groups were compared; the Oswestry dysfunction score and VAS pain score before treatment, and 1, 3 and 6 months after treatment, and changes of cellular levels of TNF-α, IL-4, IL-6, CD3⁺, CD4⁺, and CD8⁺ before treatment, and 24 and 48 h after surgery were evaluated. Length of surgical incision, intraoperative blood loss, time of operation, time in bed, and hospital stays of patients in minimally invasive group were lower than those in the fenestration group (P<0.05). The Oswestry score and VAS score of patients in minimally invasive group 1, 3 and 6 months after surgery were lower than those in fenestration group (P<0.05). The incidence rate of spinal instability and overall incidence of complications of patients in minimally invasive group were significantly lower than those in fenestration group (P<0.05). Levels of TNF-α and IL-6 of patients in the minimally invasive group 24 and 48 h after surgery were lower than those in the fenestration group (P<0.05) and cellular levels of IL-4, CD3⁺, CD4⁺, and CD8⁺ were higher (P<0.05). In conclusion, endoscopic removal of NP of IVD has good therapeutic effects in patients with LIDP. It reduces inflammation and suppresses immune function with higher safety, worthwhile for clinical use.

Keywords: endoscopic removal of nucleus pulposus of intervertebral disc; immune function; inflammatory factors; lumbar intervertebral disc protrusion.