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The First People’s Hospital of Nanning Successfully Performs the First PRP Injection Combined with Annular Repair under AUSS in Guangxi Province
Date：2025-09-05 Read：
Recently, a team from the First People’s Hospital of Nanning, led by Prof. Ronghe Gu, successfully carried out a “one-stop” minimally invasive treatment for a case of two-segment lumbar disc herniation. Under Arthroscopic-assisted Uni-portal Spinal Surgery (AUSS/UNSES), the team completed L4–5 interbody fusion and fixation together with L5–S1 nerve root decompression and repair in a single procedure. For the first time, platelet-rich plasma (PRP) injection was combined with annulus fibrosus repair in clinical practice, achieving the triple goals of decompression, repair, and regeneration.
Case Presentation
The patient, a 47-year-old female, was admitted due to recurrent low back pain for more than two years, which had worsened in the past two weeks with left lower limb radiating pain. Two years earlier, she developed low back pain without obvious cause, but no radiating symptoms. The pain recurred intermittently and was never systematically treated. Two weeks before admission, her symptoms worsened after bending and lifting a heavy object, accompanied by radiating numbness, pain, and weakness in the left leg, with restricted walking. Conservative treatment showed poor efficacy.
Examination revealed: straightened lumbar lordosis, tenderness and percussion pain over L3–S1 spinous processes and paravertebral regions, positive straight leg raise and reinforcement tests on the left side, hypoesthesia over the left lateral calf and dorsum of the foot, and muscle strength grade III in multiple muscle groups including the left tibialis anterior and extensor hallucis longus. MRI showed L4–5 left posterolateral disc herniation with spinal canal stenosis, L5–S1 disc degeneration with bulging, and osteophyte formation. The diagnosis was lumbar disc herniation with radiculopathy and lumbar spinal canal stenosis.
Considering the two-segment pathology, Prof. Gu’s team conducted thorough preoperative discussions. To balance nerve decompression and functional preservation, the final surgical plan was determined as: L4–5 vertebral body fusion and fixation under AUSS/UNSES, and L5–S1 discectomy combined with PRP injection and annulus fibrosus repair. This approach aimed to enhance repair, reduce the risk of recurrence, and maximize spinal functional recovery.
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