Comparative Clinical Research On Minimally Invasive Surgery In Quadrant Channel System And Open Operation For Protrusion Of Lumbar Intervertebral Disc With Spine Instability

Aim Analysis comparison the short-term and medium term clinical curative effect of minimally invasive surgery in Quadrant system and open operation for Protrusion of lumbar Inter vertebral Disc with Spine Instabi lity separately, and find advantages and disadvantages of both.Methods Patients with protrusion of lumbar intervertebral disc with lumbar spine instability, who were in our hospital from 2010 Sep. to 2013 Mar. and fit for inclusion criteria and exclusion criteria, are divided into A group(adopting minimally invasive surgery in quadrant channel system) and B group(adopting open operation). compare the surgery time, fluoroscopy times and blood loss volume during operation, time for patients to go on ground, hospital stays, recovery time and complications after operation. Follow-up visit and comparison of VAS, JOA, ODI, in the third month, sixth month, twelfth month and twenty-fourth month after operation. adopt Lumbar radiographs and dynamic X-ray to assess the nail situation and lumbar pedicle screw stable situation.Results Comparing the surgery time, fluoroscopy times and blood loss volume during operation, time for patients to go on ground, hospital stays, recovery time and complications after operation of the two group, we got P<0.05, indicating the differences has statistical significance. during hospitalization and Follow-up visit, no patient experienced either the nerve root or cauda equina injury, cerebrospinal fluid leakage and other complications, nor the drop-off nails, broken rods and other complications. comparing the complications of both groups, we get P>0.05, indicating the difference has no statistic significance. In the first month after operation, the average VAS score of group A is 3.57±2.19 and the average VAS score of group B is 4.58±3.02, and P<0.05. The comparison of lumbago VAS scores and skelalgia VAS scores of both groups has no statistic significance. Because of the VAS of the 12 t h month(1.45±0.64Vs1.52±0.49), 24 t h month(0.33±0.35Vs0.38±0.77) and P>0.05, the comparison difference has no statistic significance. In the 1s t month after operation, the lumbar vertebra ODI score of group A is 26.3±7.9 and the lumbar vertebra ODI score of group B is 38.7±10.8, and P<0.05, so the two scores comparison difference has statistic difference. because of the ODI score of the 12 t h month(2.5±2.2Vs4.2±3.8), 24 t h month(5.0±1.9Vs5.6±3.1) and P>0.05, the comparison difference has no statistic significance.In according to the analysis above, patients in both groups have no difference in medium and long-term curative effect after the 3r d month. In the aspects of incision length, blood loss volume during the surgery, postoperative ambulation time and postoperative short-term relief of pain, there are significant differences in the two groups and the curative effect in group A is better than that in group B. But in the aspects of fluoroscopy times and surgery time, group B is better than group A.Conclusion Lumbar discectomy and fusion internal fixation in Quadrant channel system for the treatment of lumbar disc herniation with lumbar spinal instability gain good clinical effect in early and medium term. It is a safe and effective minimally invasive surgical technique, expected to be the treatment of protrusion of lumbar intervertebral disc with lumbar spine instability.