To Investigate The Impact Of The End Plate Modic Changes In Clinical Efficacy Of Two Different Surgical Approach Treatment Of Lumbar Disc Herniation

Objective:Through analysis and comparison the Clinical efficacy of Interlaminardiscectomy treat with or without end plate Modic changes in patients with lumbar discherniation, and analysis and comparison clinical efficacy of Interbody fusion internalfixation Treat with or without end plate Modic changes of lumbar disc herniation inpatients with non-partners, to investigate the impact of the end plate Modic changes in theclinical efficacy of surgical treatment of lumbar disc herniation.Methods: In the same orthopedic spine treatment group, Randomly selected Lumbardisc herniation80cases of single segment by surgery From March2012to July2013,Which without end plate Modic changes in40cases; with end plate Modic changesassociated with40cases. Without end plate Modic changes adopted in cases betweenfenestration discectomy is20cases (A group); Interbody fusion using internal fixation in20patients (group B);Patients with end plate Modic changes adopted between fenestrationdiscectomy20cases (group C); Interbody fusion using internal fixation in20patients(group D). According to the preoperative, Oswestry disability index (ODI score) after amonth and when the last follow-up, the clinical efficacy of low back pain evaluation form(JOA score) and VAS (visual analogue scale) score evaluable patients; measure interbodyfusion group preoperative and postoperative intervertebral height, the height of the impactevaluation of Modic changes to the intervertebral space, intraoperative management Modicchanges on postoperative intervertebral area is highly influential; after three months offusion segments row CT reconstruction of fusion situation.Results:Followed for6to24months, an average of15months. A, B, C, D fourgroups of patients after one month and final follow-up ODI score, JOA score, VAS scoreswere significantly lower than before surgery, with statistical significance (P <0.01), the endof the follow-up ODI score, JOA score, VAS scores were lower than after a month, withstatistical significance (P <0.01). A, no significant difference (P>0.05) between groups before comparing preoperative C, after a month, the last follow-up were statisticallysignificant (P <0.05); pre-B, Group D comparison between preoperative and postoperative1month, last follow-up were not statistically different (P>0.05). B, were statisticallydifferent (P <0.05) the ratio of the front edge of the D after two groups of patients aftersurgery three months and final follow-up surgery segmental vertebral disc space heightwith the host, after three months and last follow-up no significant difference (P>0.05)between the comparison, B, there are relatively surgery before significant differencebetween group D (P <0.05), after a month, the last follow-up were not statistically different(P>0.05). B, D group after three months segmental fusion surgery without significantdifference (P>0.05).Conclusion:Interlaminar discectomy and interbody fusion and internal fixation areeffective surgical treatment of lumbar disc herniation way; Modic changes betweenfenestration discectomy surgery affect clinical efficacy, without Modic change surgeryafter effective than Modic changes associated with the case group; influence the clinicalefficacy of fixation Modic changes interbody fusion obvious, segmental lesions associatedwith Modic changes in intervertebral lumbar disc herniation height of less than no Modicchanges in patients, surgery should be noted that local processing Modic changes, avoidingbone hardening region, its influence is not obvious after fusion conditions.