Efficacy of transforaminal endoscopic spine system technique in treating lumbar disc herniation complicated with Ⅰ degree stability of lumbar spondylolisthesis / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of transforanminal endoscopic spine system (TESSYS) technique in treating lumbar disc herniation complicated with Ⅰ degree stability of lumbar spondylolisthesis.Methods Thirty-two patients with lumbar disc herniation,aged 51-82 yr,weighing 52-93 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n=16 each) according to whether patients had lumbar spondylolisthesislumbar disc herniation group (Y group) and lumbar disc herniation combined with Ⅰ degree stability of lumbar spondylolisthesis group (Y+Z group).Extirpated protrusion,plasty ligamenum flavum and posterior longitudinal ligament and nerve root decompression were carried out using TESSYS technique in two groups,and in addition excision of osseous neoplasias and retro-positioned posterior margin of lumbar vertebral body was done in group Y+Z.Pain was assessed using Visual Analogue Scale (VAS) score at 1 day before surgery and 3 days and 1,3,6 and 12 months after surgery.Patient's function was assessed by using the Oswestry Disability Index (ODI) at 1 day before surgery and 12 months after surgery.The therapeutic effect was evaluated using modified Macnab criteria at 12 months after surgery.Results Compared with the baseline at 1 day before surgery,VAS scores were significantly decreased at each time point after surgery,and ODI was decreased at 12 months after surgery in two groups (P＜0.05).Compared with group Y,VAS scores were significantly decreased at 3 and 6 months after surgery (P＜0.05),and no significant change was found in ODI at each time point or VAS scores and Macnab outcome grade at 12 months after surgery in group Y+Z (P＞ 0.05).Conclusion TESSYS technique can be used to treat lumbar disc herniation complicated with Ⅰ degree stability of lumbar spondylolisthesis.