Observation on the effect of the treatment of lumbar disc herniation with lateral recess stenosis through the interlaminar approach under the technique of intervertebral foramen / 临床外科杂志

Objective This study explored the clinical effect of using transforaminal technique to treat patients with lumbar disc herniation and lateral recess stenosis.Methods 132 patients with lumbar disc herniation and lateral recess stenosis who were treated by orthopedic surgery in our hospital from July 2018 to December 2022 were selected for retrospective analysis.They were divided into the endoscopic group and the traditional group according to the surgical method.70 patients in the endoscopic group were treated by the inter-laminar approach under the technique of intervertebral foramen,and 62 patients in the traditional group were treated by the traditional open surgery.The operation process indexes of the two methods were compared The clinical symptoms of patients after operation were different.Results The average operation time[(76.1±7.5)min],surgical blood loss[(30.5±8.4)ml],incision length[(0.88±0.12)cm],post-operative drainage[(24.5±4.4)ml],bed time[(26.8±4.4)h],and length of stay[(5.6±1.8)d]in the endoscopic group were significantly lower than those in the traditional group[(88.0±9.3)min,(103.4±18.6)ml,(6.10±1.04)cm,(208.3±34.0)ml,(32.7±6.6)h and(9.4±2.0)d,respectively].The difference was statistically significant(P＜0.05).VAS scores of 3 months and 6 months after surgery were lower than those before surgery,and JO A scores were higher,the difference was statistically significant(P＜0.05).The lumbar function of the endoscopic group was excellent in 43 cases(61.43％)and good in 15 cases(21.43)％),29 cases of lumbar spine function were excellent(46.77％)and 17 cases(21.43％)were good in the traditional group.Overall,there was no statistically significant difference in the recovery of lumbar spine function between the endoscopic group and the traditional group(P＞0.05).2 patients(2.86％)in the endoscopy group had postoperative complications,and 7 patients(11.29％)in the traditional group had postoperative complications,but there was no significant statistical difference in the incidence of surgical complications between the two groups(P＞0.05).Conclusion For the treatment of lumbar disc herniation with lateral recess stenosis under intervertebral foraminal technique,the treatment of lumbar intervertebral disc herniation with lateral recess stenosis can achieve better functional recovery and effectively relieve the clinical symptoms of the patient,but its advantage lies in the operation time.Shorter,less traumatic impact on patients.

The theory of emphasizing both muscles and bones in the treatment of lumbar intervertebral disc herniation / 国际中医中药杂志

The theory of "equal stress on bones and muscles" emphasizes that "the tendons bind to the bones, the bones are stretched, the bones are connected, and the bones are fractured. The relationship between bone and soft tissues are important, which is the law of Traditional Chinese Medicine in the treatment of orthopedic diseases. For patients with lumbar disc herniation, the percutaneous intervertebral foraminal technology remodels the disordered internal biological balance of the spine under pathological conditions. Among them, two common clinical minimally invasive approaches under endoscopy are paid attention to soft tissue protection, and active and appropriate functional exercises after surgery, which have become a typical manifestation of the theory of "equal stress on bones and muscles" in modern spinal orthopedic surgery.