Résumé
Objective To evaluate the efficacy of percutaneous transforaminal endoscopic discectomy ( PTED) in the treatment of obese patients with lumbar disc herniation (LDH).Methods From February 2015 to January 2017,52 obese patients with lumbar disc herniation who underwent percutaneous endoscopic surgery were included in this study .Comparison of preoperative and postoperative 1 week,3 months, 6 months and 12 months VAS,JOA and modified MacNab criteria were employed to measure the clinical outcome .Complications during and after the operation were recorded to evaluate the safety of surgery .Results All the patients were followed up for 6 to 12 months,average of 8 months.Four patients experienced abnormal sensations in the nerve root exit zone postoperatively ,and disapperaed after 3 days of treatment with dehydratio and administration of hormone .Three cases of recurrence were observed at 3 months,6 months and 7 months postoperatively and were treated by open window discetomy .The postoperative VAS scores were significantly reduced compared to that before the operation , with significant difference(P<0.05).The JOA scores had significantly improved after surgery (P<0.05).In the last follow-up,the clinical effects of modified Macnab criteria were evaluated ,excellent in 16 cases,good in 29,fair in 4 cases,poor in 3 cases,and 86.5％of patients had excellent and good outcomes .Conclusion Percutaneous transforaminal endoscopic discectomy is effective for obese patients with lumbar disc herniation ,which has the advantages of minimally invasive ,less bleeding and quick recovery for the patients .