Percutaneous Endoscopic Lumbar Discectomy Combined with Annular Suture: Technical Video

In this study, we introduce a technique that combines percutaneous endoscopic lumbar discectomy (PELD) with annular suture, aiming to reduce postoperative recurrence rates and enhance clinical outcomes for patients. The repair of the annulus fibrosus plays a pivotal role in healing ruptured scars, reducing the rate of nuclear reherniation, and enhancing the hardness of scar tissue through surgical intervention. Younger patients, with their higher water content in the intervertebral discs and stronger nucleus pulposus tissue, are more suitable candidates for tissue suturing, thus achieving a higher success rate. For older patients, annular suture may present more challenges; however, proper repair can still yield lasting clinical effects. Furthermore, we provide a detailed description of the extent of discectomy during surgery to ensure effective decompression. We performed a more extensive discectomy but combined it with annular repair, which not only alleviates pressure but also preserves more of the nucleus pulposus, delaying the loss of disc height and endplate degeneration, thereby enhancing spinal stability. To enhance the safety and efficacy of the surgery, we present a detailed video demonstration of the PELD procedure and annular suture. The video showcases the use of suture needles of specific dimensions to ensure precision and effectiveness in the repair process. This meticulous approach not only improves patient outcomes but also contributes to a swifter return to daily activities, reducing the risk of long-term complications.