The effective of percutaneous endoscopic lumbar discectomy for L5/S1 disc herniation via an interlaminar approach versus a transforaminal approach / 中国医师杂志

ABSTRACT

Objective To compare the clinical results of percutaneous endoscopic interlaminar discectomy (PEID) and percutaneous endoscopic transforaminal discectomy (PETD) in L5/S1 disc herniation.Methods A total of 102 patients with L5/S1 disc herniation in our hospital from September 2014 to June 2016 were enrolled in this study.Fifty-two patients underwent percutaneous endoscopic interlaminar discectomy (PEID group) and 50 patients underwent percutaneous endoscopic transforaminal discectomy (PETD group).The surgical effectiveness was assessed according to Visual Analog Scale (VAS),Oswestry Disability Index (ODI),and modified MacNab criteria.The frequencies of intraoperative radiation exposure,operation time and complication rates were compared between the groups.Results All the patients completed follow up with a mean of 15.0 months (range,10-20 months).In the PEID group,the mean operation time was 44-72 (58.3 ± 12.0)minutes and the intraoperative frequencies of radiation exposure were 3-6(3.8 ±2.1)seconds.For the PETD group,the mean operation time was 52-96(82.4 ± 16.0) minutes and the intraoperative radiation time was 13-34 (24.1 ± 10.1) seconds.There were significant differences in operation time and radiation frequency between the two groups (P ＜ 0.05).The postoperative VAS and ODI were obviously improved in both groups when compared with preoperation (P ＜ 0.05),but there were no significant differences between the two groups (P ＞ 0.05).There was no statistically significant difference considering the satisfactory rates according to the MacNab criteria between PEID group (96.1％) and PETD group (96.0％).Conclusions The treatment of L5/S1 disc herniation through lamina or intervertebral foramen approach is both effective.PEID can significantly reduce the frequencies of intraoperative radiation exposure and operation time.