Comparison of Spinal Bone Removal Scale with MED and IFAD and Their Postoperative Effects on Lumbar Degeneration / 中国微创外科杂志

ABSTRACT

Objective To compare the scale of the spinal bones removed by microendoscopic discectomy (MED) and interlaminal fenestration approach discectomy (IFAD),and their postoperative influence on the lumber degeneration in patients with lumber disc herniation.Methods Totally 76 cases of MED and 80 cases of IFAD were enrolled in this study.The scale of the spinal bones resected were compared by measuring the width and height of the bone window,as well as the percentages of the removed superior and inferior articular processes by using X-ray.To compare the efficacy of the two procedures,Nakai criteria was employed. The height and angle of intervertebral space and intervertebral displacement were detected preoperation,and then were followed up after the surgery.Results Both the width and height of the bone window and the percentages of the removed superior and inferior articular processes of the MED group was significantly less than those in the IFAD group (P=0.000);whereas,no marked difference was found in the scale of disc removal between the two group[(1.75?0.58) g vs (1.95?0.77)g,t=-1.825,P=0.070].The outcomes of the two group was similar,the rate of excellent and good outcomes of the MED and IFAD groups were 86.8% and 88.8%, respectively (Z=-0.184,P=0.854).In the MED group,the intervertebral space was reduced by 30%?18%,which were similar to that in the IFAD group 34%?15%(t=-1.246,P=0.215);3 cases of the MED group and 5 of the IFAD group had intervertebral instability after the surgery (x~2=0.425,P=0.515).Conclusions Both MED and IFAD are effective for lumbar disc herniation.However,MED shoud be the first choice for the disease,because the procedure causes less trauma.