| Objective: Percutaneous endoscopic transforaminal discectomy(PETD)and percutaneous endoscopic interlaminar discectomy(PEID)were used to treat the lumbar spine Lateral recess stenosis.Then compared their short-term results and decompression area of disk clearance level.Methods: A retrospective study was performed to collect 50 patients with single-segment lateral recess stenosis of disk clearance level between January 2015 and January 2017 in our hospital.25 cases underwent percutaneous endoscopic transforaminal approach decompression,while the remaining 25 cases underwent percutaneous endoscopic interlaminar decompression.The general data such as gender,age,nerve compression location and lesion size were compared between the two groups.The patients were followed up for 1 year.Visual analogue scale(VAS)and 0swestry disabilitv index(ODI)were evaluated.The preoperative and postoperative scores of the two groups were compared.The final follow-up evaluation was performed using the modified Mac Nab standard.Record and compare the number of intraoperative fluoroscopy,total operation time,postoperative bed rest and hospital stay.CT was reviewed the next day after operation.The area of ??lateral recess was measured preoperatively and postoperatively by computed and software.The preoperative stenosis area,postoperative stenosis area,area difference and difference ratio were compared.Results: The average age of two groups of patients was 61.04 ± 9.51 years old and59.08 ± 9.29 years old,respectively,with no significant difference in age and gender.The operative segments were L3 / 4,L4 / 5,L5 / S1.In the PETD treatment group,there were 14 cases(56%)in the anterior compression group,9 cases(36%)in the anterior compression group and 2 cases(8%)in the anterior and posterior compression group.However in the PEID treatment group,there were 10 cases(40%)in the anterior compression group,14 cases(56%)in the anterior compression group and 1 cases(4%)in the anterior and posterior compression group.There was no statistical differences.Tn the first group,preoperative and postoperative VAS scores were 7.28 ± 0.94 and 1.84± 0.55 respectively,while the ODIs were 65.36 ± 8.78 and 13.84 ± 5.57,respectively,which were significantly different from those before operation.In the second group,preoperative and postoperative VAS scores were 7.36 ± 0.95 and 2.16± 0.62,respectively,and ODI values were 63.68 ± 9.66 and 13.84 ± 5.57 respectively,which were significantly different from those before operation.But there was no significantly difference between the too groups.Patients with leg pain were reduced compared with preoperative,the last follow-up recorded patients with Mac Nab,PETD excellent 9 cases,good in 14 cases,fair in 2 cases,poor in 0 cases,excellent and good rate of 92%;PEID group excellent in 11 cases,good in 11 cases,Cases,poor in 1case,good rate of 88%,and there was no difference between the two groups.The preoperative and postoperative stenosis areas of PETD group were 52.20mm2±8.40mm2,6.96 ± 1.27mm2,respectively,which were significantly different from those before operation.The preoperative and postoperative stenosis area of PETID group were 51.36 ± 6.93mm2 and 8.04 ± 1.70 mm2,compared with the preoperative statistically significant difference,but there was no significant difference between groups.The former area reduced 45.24 ± 8.39mm2,the rate of reduced area was 86.35± 3.43%,and the latter area reduced 43.32 ± 7.19mm2,the rate of reduced was 84.6± 4.19%,with no significant difference between the two groups.The number of fluoroscopy in PETD group and PEID group were 22.28 ± 4.50 times and 3.36 ±1.14 times,with significant difference between groups.The total operation time was72.80 ± 9.02 minutes in PETD group and 60.40 ± 8.77 minutes in PEID group,with no significant difference between the two groups.But there was no significant difference in hospitalization time.All patients without severe tear,cerebrospinal fluid leakage,lower limb paralysis and other serious complications.PEID group had 3 cases of sunburn syndrome,recovering after conservative treatment of drug remission.Postoperative follow-up PEID group,1 case of recurrence,re-emergencing lower extremity radiating pain ine 6 months later,and review of CT showed a new disc herniation.With conservative treatment ineffective,his lower extremity pain relief after PETD.There was no recurrence ine PETD group.Conclusion: The study found that PETD and PEID are effective in treating narrow stenosis of the disc space and can effectively decompress the nerve root.But each has its advantages and disadvantages,the former in the treatment of calcified intervertebral disc and vertebral trabecular hyperplasia has obvious advantages,the latter without expanding the shape,can directly decompression dorsal root.Depending on the site of the stenosis,safer and more reliable procedures are chosen. |
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