| Objective The main reason of lumbar disc herniation is lumbar disc degeneration, the fiber ring edge broken lead to bulge out of nucleus pulposus from rupture, nerve root, horsetail nerve stimulation or oppression, which will cause a series of clinical symptoms, the most prominent feature is the cause of patients with waist and leg pain. According to the site of nucleus pulposus, lumbar disc herniation Includes three types, they are named the central type protruding, posterolateralprotrusion and foraminal herniation. Lumbar disc herniation can be divided into the bulging, prominent, hernia, free type combined with imaging examination. Most of the patients choose conservative treatment and sometimes can be cured by it, but there are still 10% to 20% of patients after conservative treatment is invalid, especially, with calcification in lumbar disc. Calcified lumbar dis heriation is a special type of lumbar disc prolapsed, not only refers to the nucleus pulposus or annulus calcification, but also can affects to the yellow ligament, longitudinal ligaments, oppressive nerve resulting in pain and other symptoms,traditional minimally invasive surgery is the noneffective in such patients, and patients of calcified lumbar disc hemiation is not suitable for line traction and massage, in order to avoid serious consequences, aggravating illness. Medical common view is that this kind of intervertebral disc herniation need to open surgery,if not it's hard to work.but open operation is trauma, bleeding, often with postoperative lumbar spinal instability risk, seriously affect the patients quality of life. With progress of modern technology, minimally invasive spine surgery is widely used in clinical, compared to traditional window operation, the minimally invasive surgery of spine has many advantages.such as small trauma, fewer complications, high security, purpose directly and fast recovery of patients. With percutaneous puncture intervertebral foramen TESSYS lens (transforaminal endoscopic spine system) technology, the advent of the indication is wide, and can be used for a variety of types of lumbar intervertebral disc herniation such as outstanding, hernia, free type, fiber ring, nucleus pulposus, yellow ligament or after longitudinal ligament calcification, etc. By comparing the analysis of the indicators of this surgery and clinical symptoms improvement,we would discuss the clinical effects of percutaneous transforaminal endoscopic discectomy using TESSYStechnology on treating calcified lumbar disc herniation. Methods From 2014-2 to 2014-9, I adopted the posterolateral approach intervertebral foramen microscopically TESSYS technology of 48 patients with calcified lumbar intervertebral disc herniation underwent surgical treatment, followed-up of 6 months, compare the preoperative and postoperative instantly,3 d,1 month.3 months.6 months the visual analogue scale (VAS), the Japanese orthopaedic association evaluation score (JOA) treatment, ODI, the last follow-up with modified MacNab criteria evaluation, analysing the recent clinical effect.Results this group of 48 patients, successful operation and follow-up, in patients with 48 cases occurred in 1 case did not stay in bed for 3 d strictly follow the doctor's advice, cause the nucleus pulposus prolapse again, hence again second surgery, surgery smoothly; 1 case because of suffering from inflammation of end plate at the same time, postoperative lower limb radiation pain, but still feeling pain, waist line on the 7th postoperative intervertebral disc injection of three oxygen, operation smoothly.More patients are performed one-time finish.48 patients each point compared with preoperative, postoperative VAS score, JOA score significantly reduced, a significant rise in Oswestry scores, the difference was statistically significant (P<0.05), after 6 months and showed immediate,3 d,1 month,3 months, compared to significantly reduce VAS score, JOA score significantly reduced, a significant rise in Oswestry scores, the difference was statistically significant (P<0.05);With immediate postoperative 3 months after operation,3 d, compared to 1 month, there was no statistically significant difference (P>0.05);Postoperative 1 month compared with the immediate postoperative,3 d, there was no statistically significant difference (P>0.05);Postoperative 3 d compared with the postoperative immediately, there was no statistically significant difference (P>0.05).Explain intervertebral foramen mirror treatment effective, calcification type lumbar intervertebral disc protrusion in June and postoperative effect is best.The last follow-up application of modified MacNab criteria to evaluate the clinical efficacy of patients,21 cases,23 cases,4 cases,0 cases,was 91.47%(44/48).Conclusion percutaneous intervertebral foramen microscopically TESSYS technology treat calcified type lumbar disc heriation is safe,effective, less adverse reaction, and has good effect after 6 months. |
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