Follow-up And Analysis Of The Efficacy Of Microendoscopic Discectomy And Percutaneous Endoscopic Lumbar Discectomy For The Treatment Of Lumbar Disc Herniation

Objective:Through the follow-up of patients with lumbar disc herniation to compare the clinical index between Percutaneous Endoscopic Lumbar Discectomy(PELD)and Microendoscopic Discectomy(MED)for the clinical treatment of LDH,and provide reference for LDH's clinical treatment.Methods : In the way of clinical retrospective study,60 patients,diagnosed with single segment lumbar disc herniation from Ocotober2013 to August 2016 were selected,and were divided into PELD group and MED group according to the operation.Record the two groups of patients with body mass index,age,the duration of the disease,TCM syndrome type,and postoperative hospital stay of the two groups patients,given the postoperative patients TCM oral preparations in hospital according to TCM Syndromes,and made a postoperative follow-up via Visual analog scale for pain,the Oswestry Disability Index for patients?function and JOA method for clinical outcome,therefore,the results were statistically analyzed to evaluate the efficacy.Results: 59 cases were retrospectively analyzed,including 28 cases,treated with MED,and others with PELD.1.Comparison of basic information: compared by one-way ANOVA analysis,there was no significant difference between the age,body mass index and duration distribution of the two groups(P>0.05),suggested that the age,body mass index and constituent ratio of the two groups are no difference.There was no significant difference for the composition of gender of the two groups(P>0.05),suggested that sex ratio of the two groups' patients showed no difference;2.There were significant differences between the two groups in the amount of bleeding,hospitalization time,hospitalization time and intraoperative blood loss(P<0.05).The results showed that PELD group was better than MED group in hospitalization time and intraoperative blood loss;3.MED group and PELD group were compared before and after curative effect score: the two groups before surgery,after surgery group comparison shows.According to lumbar JOA,VAS,ODI score comparison,MED group and PELD group after surgery symptoms and function were significantly higher than preoperative(P<0.05),indicated that patients with postoperative symptoms improved significantly;4.MED group and PELD group before and after surgery curative effect score comparison.There was no significant difference between the two groups in JOA,VAS and ODI score(P>0.05),Two groups achieved similar clinical efficacy during the follow-up period,There was significant difference in VAS score between the two groups after surgery(P<0.05)for 3 days,The results showed that PELD group was significantly better than MED group in 3 days after operation;5.MED group and PELD group of different ages,body mass index,TCM syndrome score: The comparison between the two groups showed that there was no significant difference between the two groups in the improvement rate of JOA of the lumbar spine and the ODI score(P>0.05).There was no difference between MED group and PELD group in different age groups,body mass index and TCM Syndrome.Conclusion:1.The two therapeutic measures of PELD and MED in this study were effective for Lumbar and leg pain caused by the lumbar disc herniation and had satisfactory clinical results,The difference in efficacy between PELD and MED is not clear,only strictly grasping the indications and skillful operations in order to get the best curative effect.2.compared to MED,PELD has some advantages of less bleeding,short postoperative hospitalization and local anesthesia and early function recovery,Especially in elderly patients with stable lumbar spine,PELD can achieve satisfactory results.