Study Of Traumatic Response In Patients Following Microendoscopic Discectomy And Open Discectomy

Background: Surgery is a special trauma ,the magnitude of the tissue damage from surgery impacts the traumatic response. This response is proportional to the severity of surgical stress. Microendoscopic Discectomy (MED)recently become more and more popular for treating Lumbar Disc Herniation (LDH) because of the less postoperative pain,less bleed , shorter hospital stay , and is associated with good clinical outcomes compared with Open Discectomy (OD).Objective:Study the different response of serum C-Reactive Protein (CRP),systemic cytokine and the magnitude of paravertebral muscle tissue damage to compared the surgical stress quantificationally in patients following MED and OD.Method: From December, 2004 to January, 2006, 44 patients who had been diagnosed single level LDH underwent MED(N = 22) and OD (N = 22). In this study, METRxⅡSystem (Sofamor Danek, USA) was used to perform the endoscopic discectomy procedure in all MED patients.1. The operating length, intraoperative blood loss, length of skin incision, postoperation hospital stay were noted in every patient. The pain severity of incision were evaluated by Visual Analog Scale (VAS) after operation both in MED and OD group.2. Serum levels of Tumor Necrosis Factor-α(TNF-α) and Interleukin-6 (IL-6) were measured before surgery and at 24, 48h after operation using an Enzyme-Linked Immuno Sorbent Assay(ELISA). Serum level of CRP was measured at the same time interval.3. Serum level of Creatine Kinase (CK) activity was measured before surgery and at 24, 48h after operation ,CK activity level in paraspinal muscle at the beginning and the end of operation were also measured.4. The clinical outcomes were evaluated by Oswestry Disability Index(ODI) before operation and 6 months follow-up after operation.Result:...