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Objective <p>To propose a new classification method based on CT three-dimensional reconstruction for inferior articular process injury following percutaneous endoscopic interlaminar lumbar discectomy (PEID), and to analyze the impact of &gt; 50% inferior articular process(IAP) defect on clinical outcomes.</p> Methods <p>A retrospective analysis was conducted on 100 PEID patients. IAP injuries were classified into four types based on CT three-dimensional reconstruction, and the inter- and intra-observer reliability was assessed using the Kappa consistency test. Patients were divided into two groups based on IAP defect size: Group A (defect ≤ 50%) and Group B (defect &gt; 50%). VAS, ODI, clinical outcomes, and lumbar instability were compared between the two groups, and IAP changes were observed.</p> Results <p>The classification showed good inter- and intra-observer consistency. There were no significant differences in VAS, ODI, clinical outcomes, or lumbar instability between the two groups (<i>P</i> &gt; 0.05). Both groups showed varying degrees of IAP regeneration and remodeling.</p> Conclusion <p>The classification of IAP injuries based on CT three-dimensional reconstruction demonstrates good inter- and intra-observer consistency. In the short term, patients with &gt; 50% IAP defects (Types III and IV) show no difference in lumbar stability or clinical outcomes compared to those with ≤ 50% defects (Types I and II).However, for patients with complete IAP loss (Type IV), the potential long-term risk of lumbar instability and related clinical complications remains a concern.</p>

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Classification of inferior articular process injury after percutaneous endoscopic interlaminar lumbar discectomy based on CT three-dimensional reconstruction and its clinical significance

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月30日

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  • Haigang Hu,
  • Chao Wu,
  • Tao Li,
  • Hong Li

摘要

Objective

To propose a new classification method based on CT three-dimensional reconstruction for inferior articular process injury following percutaneous endoscopic interlaminar lumbar discectomy (PEID), and to analyze the impact of > 50% inferior articular process(IAP) defect on clinical outcomes.

Methods

A retrospective analysis was conducted on 100 PEID patients. IAP injuries were classified into four types based on CT three-dimensional reconstruction, and the inter- and intra-observer reliability was assessed using the Kappa consistency test. Patients were divided into two groups based on IAP defect size: Group A (defect ≤ 50%) and Group B (defect > 50%). VAS, ODI, clinical outcomes, and lumbar instability were compared between the two groups, and IAP changes were observed.

Results

The classification showed good inter- and intra-observer consistency. There were no significant differences in VAS, ODI, clinical outcomes, or lumbar instability between the two groups (P > 0.05). Both groups showed varying degrees of IAP regeneration and remodeling.

Conclusion

The classification of IAP injuries based on CT three-dimensional reconstruction demonstrates good inter- and intra-observer consistency. In the short term, patients with > 50% IAP defects (Types III and IV) show no difference in lumbar stability or clinical outcomes compared to those with ≤ 50% defects (Types I and II).However, for patients with complete IAP loss (Type IV), the potential long-term risk of lumbar instability and related clinical complications remains a concern.