Curative Effect Evaluation Of Microendoscopic Discectomy And Open Discectomy In Treating Lumbar Disc Herniation

Objectives:To observe and analyze the difference of lumbar spine stability and muscle tissue damage to compare the different levels of reaction to lumbar spine stability and traumatic in patients following Microendoscopic Discectomy and open discectomy. Methods:From August,2008 to July,2009,50 patients who had been diagnosed single level LDH underwent MED(N=25)and FD(N=25). The differences of operating length, intraoperative blood loss, length of skin incision, time in intraoperative, postoperation hospital stay, Visual Analog Scale and clinical effects were compared. Serum level of Creatinekinase (CK) activity and C-Reactive Protein were measured before surgery and at 24,48h after operation. All patients were measured the horizontal displacement and angular displacement at preoperative and 2W,3M,6M after operation. Measured the amount of horizontal displacement and the change of angular displacement on the flexion/extension. Results:The MED patients had shorter size of skin incision and less intraoperative blood loss, and patients-pain severity of the skin incision was less in MED group than FD group. Time needed before ambulation and operation and the length of hospital stay was shorter in MED group, and there was no difference in clinical outcomes between MED and FD group. CRP level and CK activity elevated after operation in both groups, and they were in FD group higher obviously than in MED group both at 24h and 48h after operation. In MED group the horizontal displacement and angular displacement displayed a less significant change after operation, but they changed remarkably in FD group especially beginning from 3M after operation. Conclusion:Both the two operative means had definite and similar therapeutic effects, however, the less lumbar spine instability and less responses of serum CRP and CK showed that the MED procedure was less traumatic.