The Short-term Curative Effect And Related Factors Of Treatment Of Percutaneous Endoscopic Lumbar Discectomy For Lumbar Disc Herniation In Adolescents

Background:Lumbar disc herniation(LDH)is a common spine disease,but compared to adults,the clinical young patients are relatively rare.As a minimally invasive spirochete surgery,the Percutaneous Endoscopic Lumbar Discectomy(PELD)surgery has achieved significant clinical results in the treatment of LDH at home and abroad.At present,the treatment of percutaneous endoscopic approach for the treatment of juvenile lumbar disc herniation has been widely recognized by doctors and scholars in the field of spine surgery both at home and abroad,and the related research reports have increased year by year,and the excellent and the rate of overall efficiency at a higher level.Objective:To observe the short-term clinical efficacy of percutaneous endoscopic approach for the treatment of juvenile lumbar disc herniation,and discuss the related factors of clinical efficacy.Methods:The clinical data of 78 patients with lumbar disc herniation who underwent single-segment PELD operation at the age of 21 years and below were collected from July 2013 to December 2016.VAS(Visual Analog Scale)and Lumbar JO A was used to analyze clinical outcome.The improvement rate of The VAS score and lumbar JOA score were analyzed retrospectively at post operative day 1 and 1～3 years.According to its clinical curative effect,it was divided into excellent group and poor group.The curative effect was influenced by 8 possible factors and these factors were analyzed by single-factor analysis and Logistic regression analysis.Results:The VAS score decreased from(5.83 ±1.11)to(1.89 ± 0.52)days first days after operation,and last follow up was(0.75 ±0.50).Among 78,one patient had the VAS score of 4 in first postoperative day.The final follow-up showed that the improvement rate of lumbar JOA score was(77.04 ± 7.28%).Statistical analysis showed that there was no significant difference between the two groups in sex,age,operation segment,fibrous ring rupture and Modic change(P>0.05),and there were statistically significant differences in the course of the disease,trauma,clinical symptoms(P<0.05).Logistic regression analysis showed that the course of the diseaseis more relevant to clinical efficacy,and the degree of risk by from high to low:the low back and legs pain(OR = 4.376),the course of the disease longer than six months(OR = 2.981),and trauma(OR = 2.361).Conclusion:The treatment of lumbar disc herniation in adolescents with percutaneous transforaminal endoscopic approach has a good short-term effect.The factors that influence the curative effect of the operation were clinical symptoms,duration of disease>6 months,history of trauma.