Comparative Analysis Of Clinical Efficacy Of Percutaneous Full-endoscopic Discectomy And Small Incision Intervertebral Fenestration Discectomy For Lumbar Disc Herniation In The Elderly Patients

With aging of our population,lumbar disc herniation is becoming a common disease in old patients and it seriously impact the quality of their lives. Old patients often fear to accept conventional surgery when consider their physical conditions and the great trauma conventional surgery brings. Considering the characteristics of senile lumbar disc herniation patients, minimally invasive surgery with the advantages of fewer trauma and fewer bleeding in the surgery procedure will become the direction in the surgical treatment of lumbar disc herniation.Objective:compare the efficacy of percutaneous full-endoscopic discectomy to small incision intervertebral fenestration discectomy for lumbar disc herniation in the elderly patients.Methods:50senile lumbar disc herniation were analyzed from2004to2012,among them,30cases were operated with percutaneous full-endoscopic discectomy and20cases were operated with small incision intervertebral fenestration discectomy. The length of surgical incision, the operating time, blood loss,time stay-in-bed,duration of hospitalization after operation,preoperative and postoperative JOA score、low back pain and leg pain VAS score and improve macnab score were compared.Results:The rate of excellent and good outcomes was no significant diference was found in percutaneous full-endoscopic discectomy group and in small incision intervertebral fenestration discectomy, and the same with the postoperative one month and three months lumbocrural pain relief. Significant differentes would be observed in the postoperative tree days patients-pain of VAS score, the blood loss, time stay-in-bed and duration of hospitalization after operation.percutaneous full-endoscopic discectomy group excellent than small incision intervertebral fenestration discectomy,Conclusion:The symptoms of the lumbar disc herniation in elderly patients can be reliefed effectively by both methods,but percutaneous full-endoscopic diacectomy has more advantages of less patients-pain sererity of the skin incision,less blood loss,lesstime stay-in-bed and early postoperative recovery more minimally invasive than small incision intervertebral fenestration discectomy.