Study Of The Modified TESSYS Technique And Fenestration Laminectomy Discectomy In The Treatment Of Lumbar Disc Herniation

Objective:To analyze the effects of modified transforaminal endoscopic spine system (TESSYS) and fenestration laminectomy discectomy (FLD) in treatment of lumber disc herniation (LDH).Methods:40 patients with single segment LDH were received surgical treatment in department of spinal surgery of the our Hospital from October 2012 to March 2015. The patients were divided into TESSYS group (experimental group,n=24) and FLD group (control group,n=16). And record the related data before, during and after operation, including course of disease, operation segment, herniation type, hospitalization days, amount of bleeding, postoperative time in bed and complications etc. Two spine surgeons follow and count the two group patients’following up of the measurement indexes such as the Japanese Orthopaedic Association (JOA) scale, Oswestry Disability Index (OD1) and Visual Analog Scale (VAS) in their pre-operative and post-operative 1,3, 6 and 12 months(1M、3M、6M、12M), to make the pre-operative and post-operative comparison and statistical analysis.All patients were followed-up 12 months.Result:There was no any complication such as dural tear, cerebrospinal fluid leak, vessel injury, postoperative hematoma or infection in two groups. However, two patients in the experimental group and three patients in the control group were appeared lower limb sensation abnormality post-operative, but the symptom disappeared within three months post-operations in all patients treatments by conservative. The average operation time was 71.04 min and 59.59 min in the experimental and the control groups, respectively. The average amount of bleeding was 34.38 ml and 71.88 ml in the experimental and the control group, respectively. Length of hospital stay was 3.13 days and 5.75 days in the experimental and the control groups.The excellent rate of JOA score was 100%　in the two groups and at last follow-up, but the length of hospital stay, amount of bleeding and postoperative bed rest time were significantly lower in the experimental group than that the control group(p< 0.05).Conclusion:1.The effects of modified TESSYS and FLD was satisfactory in the treatment of LDH patients.2. The modified TESSYS had advantages of less trauma and quicker recovery than FLD,but could not full substitute of the FLD yet.