Comparative Study Of Percutaneous Endoscopic Lumbar Discectomy And Fenestration Discectomy For Lumbar Disc Herniation

BackgroundDespite the higher risk of surgery and fewer indications,minimally invasive technology developed rapidly with the science and technology developed and the people's living standard improved,the patients accept minimally invasive treatment easily,Orthopedic surgeon is more and more get the favour of percutaneous transforaminal endoscopic discectomy(PTED).The standard operation for lumbar disc herniation(LDH)is fenestration discectomy(FD)and satisfactory clinical results have been achieved.However,there are still some shortcomings such as spinal instability,scarring and neuronal connection after FD.In this background,we compared the clinical effects of PELD and FD for mono-segment lumbar disc herniation,providing a certain reference in clinical application for orthopedic surgeons.ObjectiveTo compare the clinical effects of percutaneous endoscopic lumbar discectomy and fenestration discectomy for mono-segment lumbar disc herniation,providing a certain reference in clinical application for orthopedic surgeons.MethodsA total of 48 cases of mono-segment lumbar disc herniation receiving surgery between Mar.2015 and Mar.2016 were analyzed.Of which,24 cases underwent PTED while 24 cases received FD by prospective random study.Counted the preoperative and postoperative Visual analogue scale(VAS),Oswestry disability index(ODI),and postoperative complications.Useing the improvement Macnab standard evaluate the clinical efficacy of two surgical procedures.ResultTwo groups of patients all had smooth surgery.The amount of bleeding was larger(mean 24.54±1.10ml)and the time was longer(mean 77.25 ± 1.27min)for FD and the intraoperative complications of FD was none.Both two groups was statistically significant(P<0.05)for VAS,ODI score preoperative to postoperative.The MacNab criteria excellent rate in six months was 83.3%,87.5%PTED and FD,respectively.where the differences were no statistically significant(P>0.05).ConclusionBoth of percutaneous transforaminal endoscopic discectomy and fenestration discectomy can alleviate the symptoms of patients effectively.Compared with fenestration discectomy,percutaneous transforaminal endoscopic discectomy has advantages such as shorter incision,less bleeding and shorter operative time.However,there were shortcomes such as higher technical requirements,steep learning curve and so on,which limited the percutaneous transforaminal endoscopic discectomy popularizing in primary hospital.