Two-year Prognosis Analysis Of Single-segment LDH Treated With Percutaneous Transforaminal Microscopy Based On COX Proportional Hazard Model

Objective: This study was designed to investigate the efficacy of percutaneous transforaminal lumbar disc herniation in the treatment of lumbar disc herniation in a retrospective cohort study of lumbar disc herniation.And related risk factors were analyzed to provide effective data analysis and related clues for optimizing clinical percutaneous transforaminal lumbar intervertebral protrusion.Methods: This study used a retrospective cohort study to collect patients with lumbar disc herniation diagnosed in our department of orthopedics from October 2016 to December 2016.128 patients who met the inclusion criteria were divided into percutaneous vertebrae.Perforated group and traditional fenestration group,percutaneous transforaminal group were treated with percutaneous transforaminal surgery.Traditional fenestration group underwent traditional open-door laminectomy,including percutaneous transforaminal group.There were 80 cases and 48 cases of traditional window operation.And before surgery,immediately after surgery,7 days after surgery,1 month after surgery,3 months after surgery,6 months after surgery,9 months after surgery,1 year after surgery,18 months after surgery,24 months after surgery,The JOA(Japanese Orthopaedic Association Scores)score and the VAS pain score(Visual Analogue Score)were scored by the lumbar spine JOA score,VAS pain score,and survival analysis.The2-year efficacy of intervertebral foramen was explored.Result1.Statistical comparison of general clinical data A total of 128 patients were enrolled in the study,including 80 patients in the percutaneous transforaminal group and 48 patients in the traditional fenestration group.Preoperative demographic data of the two groups,including age,gender,disease duration,lumbar intervertebral responsibility segment,BMI(Body Mass Index),operative time,bleeding volume,postoperative activity time,preoperative VAS score,There was no significant difference in preoperative JOA scores by statistical analysis(P>0.05).2.Efficacy evaluation2.1 Comparison of JOA scores between preoperative and postoperative 2 years The mean and standard deviation of the JOA scores of the two groups were compared between the preoperative and postoperative 2 years.After comparison within the group,the JOA scores of the two groups were significantly increased before and 2 years after operation,and the difference was statistically significant(P<0.05).The results suggest that both surgical treatment methods are effective;There was no significant difference in the JOA score between the preoperative percutaneous transforaminal group and the traditional fenestration group(P>0.05).The percutaneous transluminal and fenestration groups were treated for 2 years after surgery.There was no significant difference in JOA scores between the two groups(P>0.05).The results showed that the lumbar spine function was improved in both groups after treatment.2.1.1 Comparison of VAS scores between preoperative and postoperative 2 years After comparison within the group,the VAS scores of the two groups were significantly increased before and 2 years after operation,and the difference was statistically significant(P<0.05).The results suggest that both surgical treatment methods are effective;There was no significant difference in the VAS score between the preoperative percutaneous transforaminal group and the traditional fenestration group(P>0.05).The percutaneous transluminal and fenestration groups were treated for 2 years after surgery.There was no significant difference in VAS scores between the time points(P>0.05).The results suggest that both surgical methods can alleviate lumbar pain.In summary,the comparison of JOA score and VAS score: the clinical efficacy of percutaneous transforaminal lumbar disc herniation is worthy of recognition,which can significantly improve the JOA score and reduce the VAS score.That is,percutaneous transforaminal technique can improve lumbar spine function and relieve lumbar pain.2.1.2 Survival analysis Using survival analysis,the percutaneous transforaminal technique was used to delay the recurrence of lumbar disc herniation in the long-term efficacy.The treatment of this study was taken as the initial event,and the recurrence of lumbar disc herniation was used as the end point event.The survival time from the start of treatment to the recurrence of lumbar disc herniation was the survival time of the patient.Through the Log-rank test and the survival curve,it can be found that the overall survival time of the two groups is about the same,that is,the percutaneous intervertebral foramen can achieve the purpose of traditional surgical treatment under the premise of minimally invasive surgery,and the traditional window opening is found.Patients in the surgical group had a longer recurrence of lumbar disc herniation after treatment than the percutaneous transforaminal group.Combined with Kaplan-Meier method univariate analysis and Cox proportional hazard model multi-factor analysis,suggesting that the group,that is,different therapies,is not the main factor affecting the survival time.Through survival analysis,we found that percutaneous transforaminal technique has a significant effect on delaying the recurrence of lumbar disc herniation in the mid-and long-term effects.Conclusion This study was based on a retrospective cohort study of percutaneous transforaminal techniques for the treatment of lumbar disc herniation.A 2-year follow-up was performed to analyze the 2-year efficacy and related risk factors for the treatment of lumbar disc herniation with percutaneous intervertebral foramen.Explore.The JOA score,VAS score,and survival analysis were the main efficacy evaluation indicators.The conclusions were as follows:1.Percutaneous transforaminal technique for the treatment of lumbar disc herniation has a prognostic effect of 2 years,which can significantly improve the function of the vertebral body and reduce the degree of lumbar pain.2.From the survival analysis,it was found that the overall recurrence rate of the two surgical methods was about the same in the 2-year prognosis analysis.This study found that the percutaneous transforaminal surgery time was slightly earlier than the traditional fenestration operation,and further research is needed.3.Percutaneous transforaminal technique has the advantages of minimally invasive,safe,and quick postoperative recovery,and can also achieve the purpose of traditional fenestration surgery,which can better provide treatment for clinicians,which is worth further promotion.