| Objective:(1)Objective to explore the effect of postural change on the height of intervertebral foramen,and to provide the theoretical support for the clinical development of intervertebral foramen;(2)Objective: to analyze retrospectively the therapeutic effect and related factors of the treatment of lumbar disc herniation with intervertebral disc endoscope.Methods:(1)Selected 30 cases of lumbar lateral position and over flexion position in the outpatient and inpatient cases of Guangxi University of traditional Chinese medicine(TCM),of which there were 16 males and females with a mean age of 21-57 years(range,years).Measurement of L4/5segment posterior height and L4/5 segment of the L5 facet to L4 in the lower margin of the pedicle lateral,hyperextension and flexion distance of 4indicators,statistical analysis on lateral radiographs of L4/5 segment and L5 posterior height to L4 pedicle articular process from the lower edge of existence the correlation and L5 facet to L4 lower margin of the pedicle in 3different posture changes.(2)The retrospective from November 2013 May-2016 in minimally invasive lumbar spine center Ruikang Hospital of Guangxi University of TCM affiliated lumbar intervertebral foramen endoscope disc herniation and followed 178 patients.The therapeutic effect was evaluated by modified Mac Nab criteria,on may affect the efficacy of age,course of disease,the same section of surgery,preoperative JOA score,preoperative VAS score,clinical symptoms,diagnosis,surgical segment,posterior longitudinal ligament rupture,protrusion calcification,surgery and complications of the 12 factors in the analysis of single factor two yuan Logistic,regression analysis multiple factors to find out influencing factors of statistical significance,explore the independent risk factors,combined with our clinical experience to explore the corresponding coping strategies.Results:(1)the accurate measurement of relevant indicators,L5 facet to L4 in the lower margin of the pedicle lateral,hyperextension and flexion distance were 8.58 ± 0.92 mm,7.20 ± 0.88 mm,10.75 ± 1.14 mm,three with a significant difference(P < 0.05);L4/5 segment posterior height 6.39 ±0.81 mm,and L5 on the lateral facet to the lower margin of the pedicle L4 the distance between the two there is a significant correlation,Pearson correlation coefficient r=0.918.(2)The results of univariate analysis showed that preoperative JOA score,preoperative VAS score,operative segment,posterior longitudinal ligament rupture,surgical complications,differences of 6 factors were not statistically significant(P>0.05);there were statistically significant differences in age,course of disease,the same section of surgery,symptoms,protrusion were calcification 5 factors(P < 0.05),and the correlation between the postoperative curative effect exists.The results of multivariate analysis showed that age,the same section of surgery,symptoms of 3 influence factors were statistically significant(P < 0.05),45 years of age or older,have the same section of surgery and numbness were independent risk of transforaminal endoscopic surgery in the treatment of lumbar disc herniation(OR = factors 5.039,3.034,5.553).Conclusions:(1)The change of body position had an effect on the height of the intervertebral foramen and the flexion position could significantly increase the height of the intervertebral foramen.(2)Therefore,the clinical development of the mirror for spinal degeneration,intervertebral space height loss patients should try to choose the flexion position surgery.Age,course of disease,the same section of surgery,symptoms,a total of 5 prominent calcification factors can influence the therapeutic efficacy of transforaminal endoscopic surgery,which were older than 45 years old,the same section of surgery and numbness were independent risk of transforaminal endoscopic surgery in the treatment of lumbar disc herniation by factors.The corresponding measures to improve the efficacy of clinical needs. |
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