| ObjectiveTo observe the operation index,short-term curative effect and complication occurrence of percutaneous transfouraminal endoscope discectomy(PTED)and small incision and lamina fenestration in patients with lumbar disc herniation,and to study the value of PTED in lumbar disc herniation.Operation time,intraoperative blood loss,incision length,incidence of complications,and the reduction of vertebral space in March.Methods80 patients with LDH in our hospital from June 2014 to May 2015 were selected to study.The patients were randomly divided into the study group and control group by simple randomized method with 40 patients each group.The control group received small incision and lamina fenestration,and the study group received PTED.Operation time,intraoperative blood loss,incision length,incidence of complications and reduction of intervertebral space height at 3 mouths after operation in patients of two groups were observd.VAS score at preoperative,1d,3 mouths and 6 mouths after operation were observed.ODI index and Lehmann lumbar function score at preoperative,3 mouths and 6mouths after operation were scored.The effect was evaluated using a modified Macnab criteria at 6 mouths after operation.Results:1.Operation and hospitalization index There were significant differences in operation time,incision length,blood loss,removing weight of intervertebral disc,bed time and length of stay between two groups(P < 0.01).The total hospital costs in the study group,which were higher than in control group,but the difference was not statistically significant between two groups(P > 0.05).2.VAS score After treatment,the 1d VAS score of the two groups were significantly lower than those before treatment,and the difference was statistically significant(P < 0.01).There were no significant differences in VAS score at between 1d,3 mouths and 6 mouths after operation(P < 0.05).The VAS score between two groups was not statisticallysignificant at all time points(P>0.05).3.ODI index The ODI index of two groups at 3 mouths after operation were lower than that at preoperation,which at 6 mouths were lower than that at preoperation and 3mouths after operation,the difference was statistically significant(P < 0.01).The ODI index between two groups was not statistically significant at all time points(P>0.05).4.Lehmann lumbar function score The scores of two groups at 1d,3m and 6m after operation were higher than that at preoperation,and scores at 3m and 6m after operation were higher than preoperation,difference of which were statistically significant(P<0.01).There was not statistically significant in scores at 3 and 6 m after operation(P > 0.05).There was no significant difference in Lehmann lumbar function between two groups(P > 0.05)at preoperation,1d,3 and 6 m after operation.5.JOAscore The JOA score in two groups at 6 mouths after operation were higher than that at preoperation,and the difference was statistically significant(P<0.01).There was no significant difference in JOA scores of two groups between before and 6 mouths after operation(P > 0.05).6.Modified Macnab criteria The excellent and good rate in control group was87.5%.The excellent and good rate in study group was 92.5%.There was no significant difference in excellent and good rate and treatment effect between two groups(P >0.05).7.Reduction of intervertebral space height at 3 mouths after operation The reduction of intervertebral space height at 3 mouths after operation in control group and study group were(8.04±1.69)% and(2.64±0.72)%,and the difference was statistically significant in reduction of intervertebral space height(P < 0.01).8.Complications The incidence of complications in the study group and the control group were 12.5% and 17.5%,respectively.There was no significant difference in incidence of complications between two groups(χ2=0.392,P =0.531).ConclusionPTED and small incision and lamina fenestration in patients with lumbar disc herniation can achieve good results,but PTED has more advantages in minimally invasive,whcih is worthy of clinical application. |
