Comparisive Of Treatment Effect Of Three Surgical Approachs In Lumbar Disc Herniation

Background:Lumbar disc herniation is a common disease of orthopaedics, that occurs in young adults. Patients are usually present with back and leg pain, sometimes cauda equina can be involved, resulting bowel and sexual function. In severe patients, the ability to work and live may be affected. Currently, severe lumbar disc herniation can be treated bysurgery primarily. It is widely treated by traditional posterior approach, and prominent nucleus are often removed by windowing, half-laminectomy, or all the whole laminectomy. Severe Patients who are liable to degenerative lumbar spinal instability after operation often undertake vertebral lamina decompression and interbody bone grafting fixation. As The two main surgical procedures have shortcomings, we propose a third surgical procedure, known as small-incision vertebral lamina windowing subtotal vertebral endplatectomy with spontaneous healing, And investigate andcompare its application and Efficacy,with the other methods.Objective:To investigate the feasibility of a surgery called small-incision vertebral window-opening subtotal endplatectomy to treat patients with good clinical indications.Method:Clinical postoperative improvement data of 15 patients underwent small trauma technique methods,45 performed radical debridement with bone fusion and internal fixation,and 25 underwent sectional Removal of end plate were retrospectively analyzed,223patients were scored and assessed by questionnaire designed by the Japanese Orthopaedic Association (JOA)Results:By compare the three groups,there was no statistical significant difference in overall postoperative improvement rate p>0.05, and no significance in subjective symptoms and daily activities limit improvement p> 0.05, and no significance in signs of improvementConclusion:in the premise of patients with the highly selective indications,small-incision vertebral lamina windowing subtotal vertebral endplatectomy with spontaneous healing is a safe and effective suigical method, and while it has the following advantages:1. less Surgery costs,2. To avoid a possibility of Lumbar disc reherniation after nucleus pulposus removement.3. less operation time and injury.4 to avoid the complications such as fixation loosening, fracture, foreign body reaction and accelerated degeneration as a result of using Rigid fixation. The only deficiency is that the surgical technique requires a skillful doctor with more experience, needs special surgical instruments. so for doctors who have more experience, this method is worth promoting.