Clinical Analysis Of Spinal Cord Endoscopy In The Treatment Of L4 / 5 Disc Herniation By Two Approaches

Objectives:Analyze and discuss the clinical effecacy of endoscopic via transforaminal or interlamin arapproach in the treatment of L4/5 intervertebral disc herniation.Method:Patients of the research were collected from 2013 March to 2014 October in the Teaching Hospital of Chengdu University of Traditional Chinese Medicine with the diagnosis of lumbar disc herniation,a retrospective analysis of 30 cases accord with the diagnosis, inclusion, exclusion criteria,15 patients who underwent transforaminal PELD operation,other 15 cases underwent interlaminar approach PELD operation.Data of the two groups were recorded respectively in preoperative, intraoperative and postoperative,including the intraoperative C arm fluoroscopy times, operation time,and so on. Pain visual analogue scale(VAS) and OSWESTRY disability index (ODI) were followed up in the preoperative and postoperative 1 day,3 monthEvaluated the clinical curative effect of this two groups with the low back pain score standard.setting by the Institute of the Department of orthopedics spine study group,statistics and analysis of the results with SPSS.Results:l.With the transforaminal approach,the intraoperative C arm fluoroscopy times were 2.73+0.70, operation time were 78.07+7.09min (p< 0.05);Wite the translaminar approach,the intraoperative C arm fluoroscopy times were 9.67+ 1.54, operation time were54.80+6.84min (p<0.05).2.1n transforaminal group, VAS score of the leg pain before operation was 7.13 +1.06,1 days after operation the score was 1.80+1.15,3 months after surgery the score was 1.47+0.99;In translaminarl group, VAS score of the leg pain before operation was 7.00±1.41,1 days after operation the score was 2.00±1.00,3 months after surgery the score was 1.67±0.98;Compared to 1 days after operation and 3 months after operation and before the operation.There were a statistically significant of the leg pain VAS score in this two different operation approach(P<0.05),but the comparison between groups shows no statistical significance (P> 0.05).3.In transforaminal group, ODI score of the leg pain before operation was67.17+ 7.87,1 days after operation the score was 18.29+4.93,3 months after surgery the score was 10.29+7.15;In translaminarl group, ODI score of the leg pain before operation was 67.80±7.30,1 days after operation the score was 19.62±5.60,3 months after surgery the score was 11.43±7.32;There were a statistically significant of the ODI score in this two different operation approach(P<0.05),but the comparison between groups shows no statistical significance (P> 0.05).4.Compare the curative effect of the leg pain in this 2 kinds of approach according to the standard of the Department of orthopedics Association spine study group,the excellent and good rate was 86.66% in transforaminal group,and in the Interlaminar approach group that was 93.33%,according to statistical analysis, P>0.05, the two groups had no statistical significance, after the operation,the total curative rate was 90% in this two approaches.Conclusion: It’s certain that the treatment of L4/5 intervertebral disc hernia-tion with percutaneous endoscopic was safe and effective,with less trauma and quicker recovery.But through interlaminar approach with shorter operation time, le ss C arm perspective,it is worthy of popularization and application.