The Mid-term Outcome Contrast Study Of Full Endoscopic Interlaminar Approach For The Surgical Treatment Of Lumbar Disc Herniation

Objective:To evaluate the minimally invasive efficacy and sargical outcome of fullendonscopic discectomy via interlaminar approach for lumbar disc herniation(LDH).Method:August2008to February2010. The patients were divided into two groups according to the surgical methods. Full endoscopic discectomy(FED)group included25males and20females, the age was20-58years with a mean(40.5±8.4)years, and the course of disease was15-150d with a mean(72.5±22.6)days. Headlamp-assisted mini-open discectomy(HAMOD)group, there were47males and35females. The age was17-63years with an average age of(42.6±9.3)years, the course of disease Was19-110d with an average (20-330)days. The mainly evaluating data include VAS (Visual analoge scale) leg、back pain, ODI (Oswestry disability index) and modified Macnab criteria with timing points at preoperative,3months,1year and final follow-up after surgery.Inter Space Height(ISH), Intervertebral Space Angle(ISA), Lumbar Lordosis Angle(LLA), and Rang Of Motion(ROM) were on lateral projection of lumbar X-ray.Result:Patients were followed up from48to66months, mean54.8±5.8months. The average operation time in full endoscopic group and the headlamp group was no statistical difference(P>0.05). The average measurable bleeding, the average hospital days, and the average after bed time was statistically significant difference in both groups(P<0.05). The complication rate in full endoscopic group Was6.6%, and in headlamp group Was4.8%, without statistical difference(P>0.05).The recurrence rate in full endoscopic group Was4.4%, and in headlamp group Was6.1%,without statistical difference(P>0.05). With regard to VAS of back pain and leg pain and ODI statistically significant difference Was found in each group between preoperatively and different periods of postoperatively, there was statistical significance in VAS back pain, ODI between the two groups(P<0.05). ISH post-operation in both tow group were lower than of pre-operation. Variation of ISH in the headlamp group were more serious than the full endoscopic group (P<0.05).ROM of post-operation in both two groups were increased than that of pre-operation. Variation of ROM in the headlamp group is more increscent than that in the full endoscopic group(P<0.05).Conclusion:Compared to the headlamp assisted mini-open technique, the full endoscopic interlaminar approach for the surgical treatment of lumbar disc herniation can achieve the better clinical outcomes with advantage of less iatrogenic trauma,sooner rehabilitation, postoperative period of incapacity and the impact of small lumbar stability.There are more advantages and value.