The Mid-term Follow-up Report Of Transforaminal Endoscopic Surgical System In The Treatment Of Lumbar Disc Herniation

Objective: Minimally invasive technique in the treatment of intervertebral disc is used widely. The near report of the effect in the treatment of lumbar disc herniation is more,and the excellent rate is over 90%. But there are few report of The Interim and the long-term efficacy observation. this paper follow-up the related patients in our hospital,and report the mid-term efficacy, clinicians on patients with postoperative clinical observation to provide reference. Methods: Adopting the retrospective analyzed method, the 54 patients of single segmental lumbar intervertebral disc protrusion(including 23 cases of L4/5 lumbar disc herniation and 31 cases of L5/S1 lumbar disc herniation) have been removed single section successfully with MED. After continuous epidural anesthesia,the patient finish the operation in TESSYS system.patients’ back and leg pain conditions have been evaluated with visual analogue scale(VAS)(ten scores) at the time of Preoperation、leaving hospital after operation、six month after operation and the last follow-up. Functional assessment has been evaluated on the basis of improved rating standard of Mac Nab. Adopting the JOA score indexes To grade LBP patients before and after operation. Results: All the procedures were performed successfully. Followed up for 3 ~ 12 months.The VAS score of low back pain was decreased from(2.36±1.30)points preoperatively to(0.76±0.70),(0.54±0.60)and(0.54±0.81)points at 3,6,and 12 months after the operation respectively. The VAS score of sciatica was decreased from(7.50±0.89)points preoperatively to(0.34±0.54),(0.16±0.35)and(0.12±0.38)points at 3,6,and 12 months after the operation respectively. The ODI score of sciatica was decreased from(73.5±9.8)points preoperatively to(25.5±5.2),(14.2±3.2)and(9.4±4.5)points at 3,6,and 12 months after the operation respectively. The JOA score of sciatica was Increased from( 12.7±0.78) points preoperatively to( 20.5±1.20),( 22.0±0.95) and( 25.1±0.68) points at 3,6,and 12 months after the operation respectively.According to the Macnab scores at 12 months after operation,there was excellent 31 cases,27 good cases,3 fair case and 0 poor case in the L4/5 LDH people; there was excellent 12 cases,9 good cases,1 fair case and 0 poor case in the L4/S1 LDH people. Conclusion: The study shows that the therapeutic effect of treating LDH with transforaminal endoscopic surgical is well. The statistical results suggest that Comparing with before surgery, low back pain symptoms of patients, 3、6 and 12 months after operation, improved significantly. Backleg pain symptoms tends to be stable after operation 6 months. Evaluation of ODI displayed, at each time point after operation, the dysfunction were significantly improved, compared with the preoperation.; The symptoms tends to be stable after operation 6 months. Postoperative JOA score display that in the Aspect of subjective symptoms, clinical signs, activities of daily living and bladder function after operation have been improved, compared with the preoperation. According to Mac Nab score, at the end of the follow-up, the excellent and good rate of more than 90% after operation. This type of operation has gradually become the ideal choice for the treatment of LDH, and it has good clinical application value.