Multi-factor Analysis Of Short-term Clinical Efficacy Of Percutaneous Transforaminal Endoscopy In The Treatment Of Lumbar Disc Herniation

Objective: To explore the related factors and independent related factors that affect the clinical efficacy of percutaneous transforaminal endoscopy in the treatment of lumbar disc herniation in the short term after operation,so as to provide a basis for preoperative evaluation of clinical efficacy in clinical work,and to make percutaneous transforaminal endoscopy in the treatment of lumbar disc herniation better applied in clinical practice.Methods: A retrospective study was conducted to investigate 89 patients with lumbar disc herniation hospitalized in the First Affiliated Hospital of Guangxi Medical University from March 2017 to September 2018 who underwent percutaneous transforaminal endoscopic nucleus pulpectomy.The age ranged from 16 to 56 years,with an average age of 35.82 years.There were55 males and 34 females.Follow-up and collection of relevant data of patients and the visual analogue scale(VAS)and Oswestry dysfunction index(ODI index)were used as indicators of clinical efficacy.The clinical efficacy was evaluated by modified MacNab score in 6 months after operation.The 11 relatedfactors that may affect the short-term clinical efficacy were scored by single factor.The relevant factors with statistical significance in univariate analysis were analyzed by multivariate logistic regression.Results: In univariate analysis,age,sex,body mass index,course of disease,operative segment,rupture of annulus fibrosus and Pfirrmann grade of lumbar intervertebral disc degeneration had no significant correlation with short-term clinical efficacy(P>0.05);Clinical symptoms,history of lumbar trauma,history of smoking,and Modic changes in the endplate of the surgical segment were significantly correlated with short-term clinical efficacy(P<0.05).In multivariate logistic regression analysis,the change of Modic in operative segment endplate was not an independent factor influencing short-term clinical efficacy(P> 0.05);The presence of low back pain in clinical symptoms,history of lumbar trauma and smoking history were independent factors influencing short-term clinical efficacy(P < 0.05).Conclusions: In this study,Percutaneous transforaminal endoscopy for the treatment of lumbar disc herniation can achieve satisfactory results.The short-term clinical efficacy after operation is affected by clinical symptoms,trauma history,smoking history and Modic changes.The presence of low back pain in clinical symptoms,history of lumbar trauma and smoking history were independent influencing factors of short-term clinical efficacy.