| Objective: To analyze the clinical curative effect of interlaminar endoscopic implementing nerve root-surrounding decompression in lumbar discectomy with ventral compression.Methods: A retrospective review was performed on 11 patients which L4/5 or L5/S1 lumbar disc herniation,male 8 cases,female 3 cases,18~74 years old,the average age was 28.82 years old.All patients do the examination of X-ray in the lateral and dynamical view of lumbar spine and CT with MRI were pertormed before operation,exclusion of lumbar instability or spinal stenosis and lateral lumbar disc herniation,the imaging examination and intraoperatively revealed lumbar disc herniation with ventral compression. Percutaneous endoscopic laser-assisted discectomy on 11 patients herniated nucleus through interlaminar approach.The difference between traditional endoscopic operation is that decompression operation from nerve root both sides called nerve root-surrounding in disc remove. Removal of nucleus pulposus and decompression from one side to another on nerve root,to realize that shoulder and axillary region combined decompression.Lumbar MRI reexamination post operation to evaluate removal of nucleus and decompression.The pain and daily activity was evaluated by the visual analog score(VAS) and the Oswestry disability index(ODI) respectively.Modified Macnab criteria were employed to measure the clinical results.Results: The operation was completed smoothly in 11 cases,with an operation time of 80~210 min(mean,117.73±40.02min),Measuring volume of the disc issue remove by drainage during the operation.The mean follow-up period was longer than 6 months(range,6-12months)in 11 patients.The mean VAS form preoperative 1week after operation 3 months after operation and 6 months after operation were 7.18±1.60、0.82±0.75、0.45±0.52、0.36±0.50.The mean ODI preoperative 3 months postoperative and 6 months postoperative is(62.91±20.68)%、(22.72±19.33)%、(7.71±5.37)%.100% of patients showed excellent(6 patients) or good(5 patients)outcomes according to the modified Macnab criteria.Conclusion: Nerve root-surrounding in lumbar discectomy via interlaminar by full-endoscopic for lumbar disc herniation with ventral compression obtained sufficient decompression and satisfactory curative effect. |
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