Clinical efficacy of percutaneous transforaminal endoscopic discectomy treatment on patients with protrusion of lumbar intervertebral disc / 中国综合临床

ABSTRACT

Objective To explore clinical efficacy of percutaneous tiansforaminal endoscopic discectomy on postoperative complications of patients with the protrusion of lumbar intervertebral disc.Methods Sixty cases of lumbar protrusion of the intervertebral disc were selected as our subjects from Nov.2012 to Nov.2013 who were hospitalized in the Seven People's Hospital of Zibo.Of which,30 cases were preformed lumbar protrusion of the intervertebral disc through transforaminal endoscopic treatment.Another 30 case were with small incision fenestration laminectomy discectomy.The information of hospitalized periods,bleeding volume,operation incision length and periods within the bed were collected.Visual analogue scale (VAS) was performed at postoperative 24,48 h.The Oswestry disability index (ODI) was applied to evaluated the daily life ability assessment of patients before surgery,1 month and 6 months after surgery.Results The incision length,intraoperative bleeding volume,postoperative bed and hospitalization periods in patients with transforaminal endoscopic treatment were ((0.7 ± 0.2) cm,(11.6 ± 2.2) ml,(27.5 ± 8.2) d,(3.3 ± 1.1) d respectively,less than that in patients with small incision fenestration laminectomy discectomy ((4.9 ± 0.2) cm,(102.9 ±16.3) ml,(94.1 ±19.7) d,(8.3 ±2.1) d).The differences were significant (t =81.332,30.403,17.095 and 11.552;P＜0.05).VAS in patients with transforaminal endoscopic treatment and in patients with small incision fenestration laminectomy discectomy were (3.7 ± 1.2) and (6.8 ± 1.9),(2.1 ± 1.1) and (5.3 ±1.6),(1.4 ±0.9) and (4.4 ± 1.5) respectively,and the differences were significant(t =7.555,9.026,9.393 ; P ＜ 0.05).The ODI in patients with transforaminal endoscopic treatment at 1 and 6 months after surgery were 12.1 ± 4.7 and 18.6 ± 3.6,higher than that in patients with small incision fenestration laminectomy discectomy(5.4 ± 2.3,13.2 ± 2.7),and the differences were significant (t =6.013,12.045 ; P ＜ 0.05).Conclusion Lumbar percutaneous transforaminal endoscopic discectomy is with obvious superiority than the method of small incision fenestration laminectomy discectomy in terms of the operation incision,intraoperative bleeding volume,postoperative bed and hospitalization time.Meanwhile,it shows the less damage to the spinal stability structure,and quick recovery.