Comparison Of Short-term Efficacy Of Percutaneous Transforaminal Endoscopy And Fenestration Discectomy For Single-segment Lumbar Disc Herniation

Objective:To prospectively observe the short-term efficacy of Percutaneous transforaminal endoscopy and fenestration discectomy in the treatment of patients with single-segment and unilateral lumbar disc herniation.Compare the short-term efficacy and clinical significance of the two procedures in the treatment of LDH patients.Methods:A total of 46 patients who were admitted to our hospital from July 2018 to July 2019 and diagnosed with single-segment unilateral lumbar disc herniation were collected.They were randomly assigned to two groups,of which 23 patients in the observation group were treated with Percutaneous transforaminal endoscopy;23 patients in the control group were treated with fenestration discectomy.Before the operation,the basic information of the two groups of patients(including gender,age(years),course of disease(months),lesion segments,etc.)are routinely recorded.Surgical index data(including operation time,blood loss during surgery,bedtime after surgery,hospital stay after surgery,etc.)and postoperative complications were recorded in two groups after surgery.During the follow-up(before surgery,at the time of discharge,1month after surgery,3 months after surgery),the pain visual analog score and Oswestry dysfunction score data of the two groups of patients were recorded.Record the modified Macnab efficacy score data at the last follow-up(6months after surgery).Observe and compare the data of the electromyography index(tibial nerve,common peroneal nerve NCV and F-wave latency)of the two groups of patients before and 3 months after the operation,and then perform statistical analysis.Results:46 cases of this subject successfully completed the operation.The patients in both groups were followed up for 3-6 months.The results show that: 1.The general data such as gender,age(years),course of disease(months),diseased segments and so on in the two groups were statistically analyzed and the P value was> 0.05.The difference was not statistically significant.The two groups were comparable.2.The operation time(min),blood loss(ml),bed time(h),and hospital stay(d)after surgery were statistically analyzed in both groups to obtain a P value of <0.05,and the difference was statistically significant.3.The VAS score data before and after follow-up in the two groups were statistically analyzed with a P value of <0.05,and the difference was statistically significant;The VAS score data at the time of discharge between the two groups was statistically analyzed and the P value was <0.05,the difference was statistically significant;The VAS score data of the two groups before operation,one month after operation,and three months after operation were statistically analyzed to obtain a P value of> 0.05,and the difference was not statistically significant.4.The ODI score data before and after follow-up in the two groups were statistically analyzed with a P value of <0.05,and the difference was statistically significant;The preoperative ODI score data between the two groups was statistically analyzed with a P value of> 0.05,and the difference was not statistically significant;The ODI score data at the time of discharge,one month after operation,and three months after operation between the two groups were statistically analyzed to obtain a P value of <0.05,and the difference was statistically significant.5.The two groups were evaluated according to the improved Mac Nab method for the excellent and good efficacy rate at 6 months after operation.The observation group was excellent with 16,good 6,fair 1,poor 0,and the overall excellent rate was95.65%.The control group was excellent 13,good 7.Fair 3,poor 0,the overall excellent rate was 86.96%,but P> 0.05,the difference was not statistically significant.6.Collect the changes of tibial nerve,common peroneal nerve NCV and tibial nerve F wave incubation period before and after surgery in the two groups of patients.Statistical analysis showed that P> 0.05,the difference was not statistically significant.7.Collect the postoperative complications of the two groups,and analyze the data to find that P > 0.05,the difference was not statistically significant.Conclusions:1.PTED and FD techniques have a good effect on patients with singlesegment unilateral lumbar disc herniation,and they can be safely and reliably used in clinical.2.PTED technology has advantages in the evaluation of recent pain relief,functional improvement,etc.3.Compared with FD,PTED has the advantages of less bleeding during operation,shorter operation time,less time in bed,and faster recovery after surgery.PTED surgery has become one of the ideal surgical procedures for the treatment of single-segment unilateral disc herniation.