The Clinical Significance Of Transforaminal Endoscopic Discectomy Typing Method On The Lumbar Disc Herniations

Lumbar disc herniations is a very common disease in department of orthopedics.Patients with symptoms of lumbar pain,unilateral or bilateral lower limb pain.Because of its recurrent disease,and there is a growing trend,so that most patients unbearable,resulting in a greater burden on patients and their relatives.Especially with the trend of aging society,the incidence rate of lumbar disc herniation is getting higher and higher.It is a research goal of many clinicians to actively seek a treatment that can stabilize the disease,improve symptoms,reduce complications and reduce disability.As a new technique for minimally invasive treatment of lumbar disc herniation,transforaminal endoscopic discectomy technology has been accepted by more and more doctors and patients.With the popularization of the technology of the transforaminal endoscopic discectomy,the surgeon has a new understanding of the lumbar disc herniation.Some scholars put forward transforaminal endoscopic discectomy typing method.And guided surgery by this type,obtained good surgical results.Objective:Classification of lumbar disc herniation by transforaminal endoscopic discectomy typing method,and guided surgery by this type.Comparison of treatment results of typing group and non type group.Discuss the clinical significance of transforaminal endoscopic discectomy typing method on the lumbar disc herniations.Methods:Treatment of 128 cases of lumbar disc herniation by percutaneous transforaminal endoscopic discectomy surgery.The changes of intervertebral disc and its relationship with nerve root were observed and recorded undermicroscope.According to the different conditions,the types of the intervertebral foramen were divided into four types: oppress type,scar type,calcification type and lateral recess stenosis type.According to the classification under the guidance of treatment.Cases of 128 cases of non-endoscopic typing of the same inclusion criteria and exclusion criteria were selected.The visual analog scale(VAS),Japanese Orthopaedic Association evaluation scores of Scores(JOA),Oswestry disability index(ODI)and Mac Nab standard to assess the efficacy of surgery.The operation time,blood loss and complication rate were recorded.And the two groups of data were statistically analyzed,so as to explore the transforaminal endoscopic discectomy typing method in the treatment of lumbar disc herniation.Results:All patients were successfully completed surgery,clinical symptoms were significantly alleviated.Typing of 128 cases of lumbar intervertebral disc herniation by transforaminal endoscopic discectomy,oppress type 60 in cases,scar type,calcification type,lateral recess stenosis type accounting for46.9%,scar type in 31 cases,accounting for 24.2%,calcification type in 23 cases,accounting for 18.0%,lateral recess stenosis type in 14 cases,accounting for 10.9.After an average(10.5+3.7)months of follow-up.The preoperative VAS score was 7.6+0.7,and the postoperative VAS score was2.5+0.6;The preoperative JOA score was 10.1+3.3,and the postoperative score was 25.6+3.8.The preoperative ODI was(62.9+5.3)%,and at the end of the follow-up ODI was(25.1+2.2)%.After the last follow-up according to the Mac Nab standard to evaluate the curative effect of modified,excellent in 75 cases,good in 47 cases,and fair in 6 cases,the excellent rate was 95.3%.Compared with preoperative,the VAS,ODI and JOA of each group were significantly improved compared with preoperative,the difference was statistically significant(P<0.05).Compared with the non typing group,the curative effect can be found,VAS,ODI,JOA score improvement rate was significantly increased(P<0.05).The ODI score of the patients in the typinggroup was significantly lower than that of the non divided group(P<0.05).The incidence of complications was significantly less than that of the non divided group(P<0.05).There was no significant difference in operation time and blood loss(P>0.05).Conclusion:As a new technology for the treatment of lumbar disc herniation,transforaminal endoscopic discectomy provides a new perspective for the observation of lumbar disc herniation.Transforaminal endoscopic discectomy typing method is expected to increase the understanding of physicians on lumbar disc herniation.The operation can be guided by transforaminal endoscopic discectomy typing method: oppress type was mainly used to treat the nucleus pulposus;scar type is mainly to solve the scar of nerve root;calcification mainly remove yellow ligament calcification;lateral recess stenosis type mainly with hypertrophy,enlarge the lateral recess,full decompression of nerve root.Through a series of targeted operations by transforaminal endoscopic discectomy typing can be achieved better than the traditional classification of endoscopic surgery.