RESUMO
Objective To investigate the clinical efficacy of microendoscopic discectomy(MED) and fanestration discectomy (FD) for treating single segement lumbar disc herniation(LDH).Methods A total of 168 patients with single segment LDH were included in this retrospective study from April 2009 to Janurary 2012.The patients were divided into MED group(81 cases) and FD group(87 cases) according to surgery mode.The operation and hospitalization indexes for each group were collected and compared respectively.The clinical outcomes were evaluated by the visual analogue scale(VAS),Japanese Orthopedic Association(JOA) scores and Oswestry Disability Index(ODD.Lumbar curves(Cobb's angle),intervertebral space height,horizontal displacement and angular displacement before and after surgery were applied to evaluate the lumbar spinal stability.Results The skin incision length,amount of intraoperative blood loss,operation time and hospitalization duration in the MED group were less than that in the FD group(P＜0.05).All cases completed follow up for more than 4 years.The each item score at last follow up in the two groups was significantly improved compared with before operation(P＜0.05),the inter-group comparison had no statistical difference(P＞0.05).The postoperative lumbar curve and intervertebral space height were decreased in both groups.The postoperative lumbar curve in the FD group was decreased compared with the MED.One case in the MED group and 3 cases in the FD group appeared lumbar vertebral instability.Conclusion Both MED and FD for treating single segment LDH can gain better clinical effect,MED has short operation time,small trauma and little influence on lumbar vertebral stability,and is an effective minimal invasive surgery.
RESUMO
Objective To evaluate the mid‐term efficacy of microendoscopic discectomy (MED) and microsurgical lumbar discectomy (MSLD) for treating lumbar disc herniation (LDH) .Methods 98 patients with single segment LDH in the Orthopedic department of the Second Hospital of Lanzhou University from March 2009 to April 2010 were divided into 2 groups ,including 44 cases undergoing MED and 54 cases undergoing MSLD .The operative efficacies were assessed by the visual analogue scale (VAS) , Japanese Orthopedic Association (JOA) scores and Oswestry Disability Index (ODI) .Results There were statistically significant differences in the skin incision length ,amount of intraoperative blood loss and time of returning to work between the two groups (P0 .05) .The mean follow‐up duration was 49 .13 months in the MED group and 47 .24 months in the MSLD group respectively .At the last follow‐up the postoperative back and leg pain VAS scores ,JOA scores and ODI in each group were signifi‐cantly improved compared with the preoperative data (P<0 .01) .However ,there were no statistically significant differences in the intergroup comparison .Conclusion MED and MSLD are the effective methods for treating single segment LDH .However ,MED has less trauma and early out‐of‐bed ambulation ,is an ideal minimally invasive surgery .