Clinical Efficacy and Mechanistic Analysis of Spinal Endoscopy Combined with Subcutaneous Nucleus Pulposus Implantation for Immune Regulation in the Treatment of Lumbar Disc Herniation
LU Zhengcao
AN Hepeng
RE Bote
BAI Jie
CAO Rui
DING Yu
Abstract：Objective To observe the impact of immune regulation via subcutaneous implantation of nucleus pulposus on the clinical efficacy of spinal endoscopic treatment for lumbar disc herniation(LDH),and to analyze the relevant immunological mechanisms.Methods The observation group was retrospectively selected and consisted of 40 LDH patients who underwent spinal endoscopic treatment combined with subcutaneous nucleus pulposus implantation for immune regulation at the Sixth Medical Center of Chinese PLA General Hospital from June 2022 to December 2023.The control group consisted of 40 LDH patients who underwent standalone spinal endoscopic treatment during the same period,selected using propensity score matching(PSM).Visual analogue scale(VAS)scores,Oswestry disability index(ODI)scores,and serum interleukin-6(IL-6)levels were compared between the two groups.Clinical efficacy was evaluated according to the modified Macnab criteria at 1 year after surgery.Results All patients in both groups underwent successful surgery,recovered well postoperatively,and experienced no complications.At all postoperative time points,VAS scores in both groups were lower than preoperative scores;specifically,VAS scores in the observation group were lower than those in the control group from postoperative days 3 to 6(P<0.05).ODI scores in both groups at 1 week and 1 month after surgery were lower than preoperative scores,and ODI scores at 1 month postoperatively were lower than those at 1 week postoperatively(P<0.05).However,there were no statistically significant differences in ODI scores between the observation group and the control group at any time point(P>0.05).On postoperative day 3,serum IL-6 levels in the observation group were higher than preoperative levels,while serum IL-6 levels in the control group were lower than preoperative levels.Moreover,serum IL-6 levels in the observation group were higher than those in the control group(P<0.05),and the proportion of patients with elevated serum IL-6 levels in the observation group on postoperative day 3 was higher than that in the control group(P<0.05).The excellent and good rate of clinical efficacy at 1 year postoperatively was 95.00%in both groups,with no statistically significant difference(P>0.05).Conclusion Spinal endoscopic treatment achieves good clinical outcomes for LDH.Combining it with immune regulation via subcutaneous nucleus pulposus implantation can significantly reduce short-term postoperative pain.The mild postoperative increase in IL-6 suggests that the mechanism may be related to mediating pain relief and neuroinflammation regulation through"local antigen presentation-systemic immune regulation."
Keywords：spinal endoscopysubcutaneous nucleus pulposus implantationimmune regulationlumbar disc herniation
Publication Date：2025-11-20
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：6( 44-49 )