A Comparative Study Of Percutaneous Transforaminal Endoscopic Discectomy Versus Intradiscal Compressive Injection For Lumbar Disc Herniation

Objective:To compare the clinical outcomes of PTED and intradiscal compressive injection(ICI)in the treatment Of LDH?Discussion them treatment effect and them recent clinical applicationMethods:In this prospective,randomized and control led study,all of 53 patients who were diagnosed as unilateral LDH with only a single segment involved from November 2014 to March 2015 in Affiliated Hospital of Yanbian University department(Into and exclusion criteria described below).Decided to group according to a random draw lots.Intradiscal compressive injection group(control group)had 3o patients,PTED group(experimental group)had 23 patients?The 23 patients who randomly divided in the experimental group was treated with PTED,and the 30 patients who randomly divided in the control group was treated with ICI.The duration of disease,gender,preoperative JOA scOre,VAS score,age,ODI score and other basic data were statistical analysis and comparison showed no significant difference between the experimental and control groups were comparable?Did not participate in the surgical procedure by two high qualification spine physicians responsible for follow-up after completion of the relevant independent scores averaged.The control group and the experimental group were followed up for a mean period of 3 months(range;1-5months)?To compare the efficacy Of two groups Of patients by measuring postoperative visual analog scale,score,Japanese orthopaedic association,oswestry disabilityindex?To evaluate the surgical treatment by MacNab criteria and JOA improvement rate?Result:All the operations were performed successfully in both control group and the experimental group.A11 patients were followed up?In the PTED group,the average incision length was(7.3±1.5)mm.and the operation time was(72.4±8.3)min.The postoperative hospital stay was(3.O±0.7)d?Both control group and the experimental group during follow-up did not appear after infection,nerve root injury,dural tears,and so on.Transient postoperative 10wer limb paresthesia two cases,to be symptomatic after treatment were followed up for one month,three months,when the symptoms disappear.The operation time was(10.2±4.1)min,incision length:pinhole size?The postoperative JOA.ODI and VAS scores in both groups were signifiantly improved when compared with those before the operation(P<0.05).The experimental group(Transforaminal endoscopic discectomy)postoperative treatment better than the control group(Intradiscal compressive injection).According to the modifid MacNab criteria,there were 86.96%good rate in the experimental group.There were 73.3%good rate in the control group.Application of fourfold table chi-square test data correction formula test,P<0.05,the experimental group than the control group.Last follow-up JOA improvement rate:87.20%for the experimental group,73.02%for the control group.Application of fourfold table chi-square test data correction formula test,P<0.05,the PTED treatment better than intradiscal compressive injection(ICI).Conclusion:Both percutaneous transforaminal endoscopic discectomy(PTED)and intradiscal compressive injection(ICI)are effective in the treatment of lumbar disc herniation.The short-term outcomes of PTED are better than ICI?PTED can nOt fully replace ICI?Comparison between the two 10ng-term effect needs further follow-up observation.