The Curative Effect Analysis Of Percutaneous Transforaminal Endoscopic Discectomy Treating The Lumbar Disc Herniation

Background and Objective: Lumbar disc herniation is a clinical common disease which cause of back and leg pain. Over the years, The main method to lumbar disc herniation is open operation treatment. But its long time operation, big trauma, slow recovery, destruction of normal spinal physiological anatomical structure, lead to spinal instability and other shortcomings attracted the attention of the surgeon Even if it have the treatment benefits. In recent years, minimally invasive treatment of lumbar disc herniation is developing rapidly, Because it have small trauma, quick recovery, short operation time,less complication it has more and more application in clinical. The percutaneous transforaminal endoscopic discectomy is one of the most important treatment of lumbar disc herniation with minimally invasive. This paper is to observe the lumbar disc herniation patients received transforaminal endoscopic discectomy in the past two years, and evaluate its curative effect.Methods: Observe the 72 lumbar disc herniation patients received transforaminal endoscopic discectomy in our department in 2013 July ~ 2014 March. the clinical efficacy was evaluated by the application of Oswestry disability index(ODI), pain visual analog scale(VAS score),improved Macnab criteria before operation, after operation in 1 months and after 3 months, 6 months, 12 months. Do MRI or CT examination to confirm whether excise the nucleus pulposus completely after operation in 3 months and 6 months.Results: The operation was successful in all patients. The operation time was 45~112min, the average 53.2±24.5min, blood loss 20 ~ 30 ml, the average blood loss was 25.4±4.3ml,the postoperative time is 14 ~ 36 h, the average was25.7±3.9h, length of hospital stay was 5 ~ 9d, the average 5.7±2.9d, none of the patients appear permanent nerve injury, vascular injury, intestinal injury,dural rupture and other complications of discitis, there were 5 cases of patients appeared the transient paralysis. All the patients were treatedwith MRI or CT examination after operation in 3 months, there were 54 cases excised the whole nucleus pulposus, and 18 cases excised the most nucleus pulposus, there were 1 case appear back and leg pain again because of recurrence on lumbar intervertebral disc protrusion after operation in 4 months, the symptom were eliminated basically by conservative treatment. Compared with preoperative VAS score,the postoperative VAS and ODI was significant lower after 1 month,3month and 6 months. In accordance with the improved Macnab evaluation criteria,the excellence rate was 91.7% after 3 month; 94.4% after 6 months; 93.0% after 12 months.Conclusions: PTED is safe and effective for treatment of lumbar disc herniation with small trauma, quick recovery, short operation time,less complication. It is worthy of clinical use.