Clinical Analysis Of Minimally Invasive Transforaminal Lumbar Interbody Fusion Versus Percutaneous Endoscopic Lumbar Discectomy For Single-level Lumbar Disc Herniation

OBJECTIVE: To systematically evaluate the clinical efficacy of minimally invasive transforaminal lumbar interbody fusion and percutaneous endoscopy lumbar discectomy in the treatment of single segmental lumbar disc herniation,and to compare the postoperative outcomes of the two treatment options.To provide a theoretical basis for the treatment of single level lumbar disc herniation.METHODS: A systematic review of 79 patients with single segmental lumbar disc herniation from Sep 2014 to Oct 2016 in the Second Hospital of Jilin University was performed.Among them,38 patients underwent minimally invasive transforaminal lumbar interbody fusion and 41 Cases of percutaneous spinal endoscopic techniques.Gender,age,body mass index,anesthesia method,operation time,intraoperative blood loss,postoperative ambulation time,average length of stay and postoperative complications were recorded in both groups,and the patients in both groups were followed up for 12 months and perfect VAS,ODI and the last follow-up Macnab score.The operation is performed by the same professor.Statistical data and assessment by the same doctor completed.All data were statistically analyzed using SPSS 21.0 statistical software (test level set as a = 0.05).Results: A total of 74 patients completed the final follow-up,of which MIS-TLIF group 35(92.11%),PELD group 39(95.12%),no significant difference between the two groups(P> 0.05).There was no significant difference in mean age,sex,body mass index between MIS-TLIF group and PELD group(P> 0.05).Mean patient age in MIS-TLIF group and PELD group were 51.49±9.94 years(51.4%female)and 48.03±15.49 years(46.2%female),respectively(P>0.05).Average operative time on the MIS-TLIF group and PELD group were 206.06±42.78 minutes and 102.87±30.45 minutes,respectively(P <0.05);average hospital stay was 8.78±3.28 days on the MIS-TLIF group and 2.97±0.54 days on the PELD group(P <0.05).Mean Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)scores decreased significantly from preoperative to all postoperative assessment times(P < 0.05).PELD group has a lower VAS and ODI compared to MIS-TLIF group at 3 days post-operation,but there was no significant difference in subsequent follow-up between the two groups.Macnab last follow-up group scores MIS-TLIF excellent and good rate 94.29%,PELD group excellent and good 92.31%.There was no statistical difference between the two groups(P > 0.05).Conclusion: 1.As minimally invasive surgery,MIS-TLIF and PTED showed favorable clinical outcomes for Single-level LDH.2.PELD might by the better choice with the advantages of less injury and faster pain relief.3.The early application of PELD has a relatively higher risk of incomplete decompression and nerve injury.