A Study Of The Recent Clinical Effective Comparation On Treating Lumbar Disc Herniation Between Percutaneous Transforaminal Endoscopic Spine System And Fenestration Laminectomy Discectomy

Objectives:1.To analyze the efficacy of percutaneous transforaminal endoscopic spine system(TESSYS)in the treatment of lumbar disc herniation;2.To compare the recent clinical effect percutaneous transfouraminal endoscopic spine system and fenestration laminectomy discectomy in the treatment of single segmental lumbar disc herniation.Methods:The clinical data of 73 patients with lumbar disc herniation who received treatment in the department of orthopedics,the fifth affiliated hospital of Kunming medical university from September 2015 to August 2017 were retrospectively analyzed.According to the surgical method,they were divided into TESSYS group,laparoscopy group(n=41)and FLD group,laparotomy group(n=32).the laparoscopy group the nerve roots were decompressed with PTED,laparotomy group adopted unilateral FLD decompression.We observed the general clinical data,SPSS 21.0 software was used for analysis,gender,age,responsible intervertebral disc,and complications had no significant differences in the two groups(P>0.05).Record the data of two groups,including incision length,operation time,postoperative bed time,postoperative average length of stay,et al.The VAS score.JOA score,and modified MacNab evaluation criteria were used to assess clinical outcomes before surgery,on the 3 days and 3 months,6 months after surgery.These dates was analyzed by SPSS 21.0 software,P<0.05,the difference was statistically significant,P>0.05,the difference was not statistically significant.Results:73 cases were successfully completed surgery,in the laparoscopy group 1 patients who undergone lumbar puncture to treat hematoma was discharged follow-up,72 cases received follow-up,follow-up time was 6 months.The two groups differences of including incision length,postoperative bed time,postoperative average length of stay were statistically significant(P<0.05),the laparoscopy group was better than the laparotomy group;The operation time differences were statistically significant(P<0.05),the laparotomy group was better than the laparoscopy group.The leg pain VAS score comparison differences has no statistical significance in two groups after 3 days,3 months,6 months(P>0.05);After 3 days the back pain VAS score had differences(P<0.05),there no differences after 3 months and 6 months(P>0.05);Modified MacNab curative effect evaluation of differences between the two groups have no statistical significance after 6 months(P>0.05);The leg pain JOA score comparison differences has no statistical significance in two groups after 3 days,3 months,6 months(P>0.05);Conclusion(s):PTED have satisfactory curative effect in treatment of lumbar disc herniation,PTED has small incision,recovery quickly,etc advantages,but there are operating space is smaller,steep learning curve,more longer operation time,etc disadvantages than FLD.