Posterior Discectomy For Lumbar Disc Herniation And Lateral Recess Stenosis Clinical Efficacy Observed

Objective To compare Microendoscopic Discectomy(MED)with normaloperational therapy method for the treatment of lumbar discherniation(LDH) with lateral stenosis and criticize the clinical effectof MEDmethod for LDH with lateral stenosis. To observe and compareshort-time and long-time outcome in patients with microendoscopicdiscectomy or traditionally open operation, investigate how to broadenthe indications of MED and make the clinical application of MED furtherprogress by the comparison with MED and open operation.Methods In the first place, the standards of fit and rejection wereformulated. We select sixty patients in hospital with lumbar discherniation during Oct1, 2004—Oct31,2006 and divide them into groupAand guoupB, each group having thirty patients. There were 30 cases withMED method as observed group and other 30 cases with normal method ascompared group. According to ODI's standard to evaluate the length ofincision,time on getting out of bed after surgery, time in hospital andtime on recovering normal living and working. All cases were followed upfrom a week, a month, three months and six months postoperatively. Aftersix months all patients were followed up each six months, includingrechecking, mailed, qestionnaire and so on. The data of observation werecollected almost completely. After that, all data were analyzed by SPSS10.0 in order to observe the obvious diffence between the both groups.By the above, good quality and defects between the two operations werefound, then further analysis and conclusion would be drawn.Results All the patients were followed up from 3 to 18 months. The dataof the other were collected(groupA 30, groupB 30).The rate of excellentand good results in observed group was 86.7%,it was 83.3%in compared groupin which there was no significant stastiscal difference in the clinical effect (P＞0.05).But there was significant stastical difference betweentwo groups in the length of incision, blood lost, operative time, thehighest body temperature after operation, time on getting out of bed afteroperation, time tn hospital and time on recovering in living and working(P＜0.01).Conclusion There was no significant for the clinical effect betweentwogroups. But MED method is better method for the treatment of LDH with withlateral stenosis because it has several advantages of minimalinvasion, shorter time of recovery, least pain and excellent effect. TheMED led to small incision, less hemorrhage, little soft tissue injury andlittle influence on the stability of the middle and posterior structureof the lumbar vertebrae. The procedure was safe and effective in a surgicalfield of magnification of several folds. Posterior spinal approachcroendoscopic discectomy for the treatment of lumbar disc herniationhas characteristics of advanced technique, minimal invasion, fastrecovery and thorough decompression to nerve roots. It has positive effectand broadly applicable future.