Efficacy of percutaneous endoscopic lumbar discectomy combined with herbal external application in elderly pa-tients with lumbar disc herniation
ZHU Wei-jiang
Abstract：Objective To evaluate the additive therapeutic effects of traditional Chinese medicine(TCM)herbal external application combined with percutaneous endoscopic lumbar discectomy(PELD)on pain relief,functional recovery,and radiological outcomes in elderly patients with lumbar disc herniation(LDH).Methods A total of 150 elderly pa-tients with LDH treated at Baise Hospital of Traditional Chinese Medicine between May 2021 and May 2022 were retro-spectively enrolled and divided into three groups:open lumbar microdiscectomy group(OLM,n=49),PELD group(n=51),and PELD combined with herbal external application group(combined group,n=50).Perioperative parameters,visual analogue scale(VAS)scores for low back and leg pain,Oswestry Disability Index(ODI),Japanese Orthopedic Association(JOA)scores,overall clinical efficacy,and radiological parameters were compared among the three groups during follow-up.Results Significant differences were observed among the three groups in operative time and intraoper-ative blood loss(P＜0.05).Postoperatively,VAS scores for low back pain and leg pain significantly improved in all groups compared with preoperative values(P＜0.05).At 6 months postoperatively,the combined group demonstrated significantly lower low back pain VAS scores and higher improvement rates than the other two groups(P＜0.05),while leg pain VAS scores at 6 and 12 months were also superior(P＜0.05).ODI and JOA scores showed significant improve-ment immediately after surgery in all groups(P＜0.05),with the combined group exhibiting significantly better outcomes from 1 month onward(P＜0.05).Total clinical efficacy rates differed significantly among groups at 1,3,and 6 months postoperatively(P＜0.05).At final follow-up,significant intergroup differences were observed in spinal canal occupa-tion rate,lumbar lordosis,pelvic tilt,thoracic kyphosis,and thoracic pelvic angle(P＜0.05),with the combined group showing superior spinal canal occupation rate and thoracic pelvic angle(P＜0.05).Conclusion Compared with tradi-tional open lumbar microdiscectomy,PELD is associated with reduced operative time and blood loss.The addition of TCM herbal external application further enhances postoperative pain relief,functional recovery,and radiological outcomes.This integrated traditional Chinese and Western medicine approach may provide superior therapeutic benefits for elderly patients with lumbar disc herniation.
Keywords：percutaneous endoscopic lumbar discectomyherbal external applicationelderly patientslumbar disc herniation
Publication Date：2026-01-15
Online Publishing Date：2026-03-04(First online date of this platform, not the publication date of the document)
Pages：9( 129-137 )