The Percutaneous Anteriorlateral Discectomy For The Interest Area Of 4/5 Lumbar From Unaffected Side

BackgroundLumbar disc herniation is a common clinical disease,patients with this disease have great pain and tend to lose labor ability. This disease need operation treatment if conservative treatment are invalid,but there are still some patients relapse after the operation,even occur the emergence of spinal instability complications. Interventional therapy and traditional open operation has the characteristics of small trauma,fewer complications,faster recovery compared to the treatment effect of the case. There are many kinds of interventional treatment of lumbar disc herniation applied in clinical practice, and currently in the continuous improvement and development. However,much more problems are still controversial,mainly in the aspects of complication and curative effect,there was no technology suitable for all patients,no technology advantage absolute safety. Interventional treatment of lumbar disc herniation technology should be further studied for various technical indications for symptoms, etiology and patients with different, choose the appropriate treatment,for a technology to deal with the mechanism of the therapeutic mechanism and complications to further clarify,improve technology and the treatment efficiency, reduce patient trauma,maximum to ensure the safety of patients. Objective,Explore the feasibility and operation technique of the percutaneous anteriorlateral 4/5 lumbar of interest discectomy afrom the contralateral in treating lumbar intervertebral disc herniation of 4/5,from the perspective of lumbar imaging 4/5 disc surrounding anatomical structures to improve the efficiency of intervention. Method50 cases of abdominal enhanced CT and lumbar MRI examination were observed L4 / 5 disc surrounding anatomical structures observed lumbar side if there safe operating area.Review the lower lumbar lateral anatomical literature.By CT or MRI and 72 patients with confirmed prominent lumbar intervertebral disc posterior 4/5 clinical symptoms be have the percutaneous anteriorlateral discectomy for the interest area of 4/5 lumbar from unaffected side guided by DSA. All cases have been more than 6 months of follow-up, using visual analog score(VAS score), Oswestry dysfunction(ODI) index and modified Mac Nab criteria to evaluate the clinical efficacy.ResultOperation front leg pain VAS index patients was 8.7 ± 2.2, 6 months after operation was 2.6 ± 1.5 before and after the operation, the difference was statistically significant(P<0.01). Patients before operation and ODI index was 65.8 ± 22.3, 3 months after operation was 23.6 ± 12, 6 months after operation was 12.9 ± 7 before and after the operation, the difference was statistically significant(P<0.01). Evaluation standard of curative effect according to the modified Mac Nab: excellent in 64 cases, good in 5 cases, 2 cases, poor in 1 cases, the excellent and good rate was 95.8%, effective rate was 98.6%, no severe complication occurred. ConclusionThe percutaneous anteriorlateral discectomy for the interest area of 4/5 lumbar from unaffected side has not important organs and blood vessels, nerve structures. By the strict selection of good indications, master operative point premise treatment satisfaction.