Effective observation on microendoscopic discectomy and fenestration discectomy for treating single segment lumbar disc herniation / 重庆医学

ABSTRACT

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.