The Clinical Effect Of Intervertebral Foraminal Endoscopy And Open Surgery In The Treatment Of Posterior Edge Separation Of Lumbar Vertebral Body

Objective: The purpose of this study is to observe and study the early clinical effects of percutaneous foraminal micro-invasive technique and traditional open interlaminar fenestration in the treatment of posterior edge separation of lumbar vertebral body.Methods: A retrospective analysis of 50 patients with lumbar vertebral body posterior margin amputated from January 2010 to June 2020 in our spinal department was performed,there were 25 patients in Group A who were treated by percutaneous intervertebral foramina(endoscopic group)and25 patients in Group B who were treated by traditional open surgery(Open Group).The operation time,intraoperative blood loss,length of surgical incision,and length of hospital stay were recorded for the two groups of patients;the efficacy was evaluated by the visual analog scale(VAS score),Oswestry dysfunction index(ODI)and Mac Nab criteria.SPSS 22.0 software was used to analyze the results.Results: both groups were operated by the same team of doctors in the same department,and all operations were successfully completed.There was no significant difference between the two groups in sex,age,course of disease and level of responsibility(P > 0.05),the difference was statistically significant(p < 0.05),and there was no significant difference in the incidence of postoperative complications between the two groups(P > 0.05).Visual analogue scale(Vas)and ODI scores of lumbago and leg pain were compared between the two groups at different time points(preoperative,postoperative 1day,postoperative 14 days,postoperative 3 months,postoperative 6 months and the last follow-up),there were significant differences between the two groups(p < 0.05)in the scores of lumbago,leg pain,Vas and ODI.The scores of lumbago,leg pain and ODI were significantly improved in both groups,the differences were statistically significant(p < 0.05).VAS scores of lumbago and leg pain on the 1st and 14 th day and ODI scores on the 1st and 14 th day after spinal endoscopic surgery were significantly higher than those in open decompression group(p < 0.05)There was no significant difference in Vas scores of lumbago and leg pain between the two groups before operation,3months after operation,6 months after operation and the last follow-up(P >0.05)There was no significant difference in ODI score before operation,3months after operation,6 months after operation and at the last follow-up between the two groups(P > 0.05).The clinical outcome of the two groups was evaluated by improved Macnab criteria at the last follow-up.The excellent and good rate was 92% in the endoscopic group and 88% in the Open Group,there was no significant difference(P > 0.05).Conclusions: 1.both minimally invasive surgery and traditional open surgery are effective in the treatment of lumbar posterior edge disconnection.2.compared with the traditional open surgery,spine minimally invasive surgery has the advantages of less surgical trauma,short hospital stay,rapid postoperative recovery,with good minimally invasive and feasible.