| Objective: To explore the safety and clinical efficacy of the TESSYS technology modified by percutaneous transforaminal endoscopic discectomy in the treatment of sequestered lumbar disc herniation.Methods: Patients who were diagnosed as sequestered lumbar disc herniation and were treated with percutaneous transforaminal surgery in the spine surgery of City Hospital from September 2015 to June 2018 are selected.According to the different surgical methods for the patients,the patients are divided into two groups which are the TESSYS technology modified by percutaneous transforaminal endoscopic discectomy group(group A)and the classical TESSYS technology group(group B),and then the patients of group A and group B are divided into mild sequestered type(A1 and B1)and highly sequestered type(A2 and B2)according to the lesion degree of protrusion of intervertebral disc.Of the 79 patients,48(60.8%)are males and 31(39.2%)are females,aged 34.1±6.3 years,with a course of disease ranging from 6 months to 2 years,and there are(65.8%)cases of mild sequestered type 52,(34.2%)cases of highly sequestered type 27,(6.3%)cases of L3/4 5,(81.0%)cases of L4/564 and(12.7%)cases of L5/S1 10.Observe and record the VAS score,JOA score and ODI index and other relate indicators of all patients in the groups at different time points before and after the operation;conduct comparative analysis of the surgical effect of the two operation method on the protrusion of intervertebraldisc patients of mild sequestered type and highly sequestered type respectively;evaluate and improve the surgical effect of TESSYS technology.Results: The surgical operations of all the grouped patients are successfully completed and the follow-up data are complete.The results of this study shows that the VAS score of the modified TESSYS technology in the treatment of protrusion of intervertebral disc patients of mild sequestered type decreases from 7.61±1.133(one day before surgery)to 2.07±.604(6months after surgery);the JOA score increases from 12.50±1.347(1 day before surgery)to24.18±1.867(6 months after surgery);the ODI score decreases from 69.79±4.349(1 day before surgery)to 19.18±2.568(6 months after surgery);other indicators are:surgery time 97.57±10.734 min,intraoperative bleeding loss 13.2±4.2 ml,intraoperative G-arm X-ray machine fluoroscopy times 6.71±1.960;the excellent and good rate of the surgery at 6 months is96.42%.The VAS score of the modified TESSYS technology in the treatment of protrusion of intervertebral disc patients of highly sequestered type decreases from 7.50±1.265(one day before the surgery)to 1.75±0.683(6 months after the surgery);the JOA score increases from11.75±1.390(1 day before the surgery)to 24.38±1.708(6 months after the surgery);the ODI score decreases from 71.56±4.320(1 day before the surgery)to 18.63±2.187(6 months after the surgery);the excellent and good rate of the surgery at 6 months is 93.75 %.Other indicators of modified TESSYS technology for protrusion of intervertebraldisc of highly sequestered type are: surgery time 105.13±7.274 min,intraoperative blood loss 14.7±3.1ml,and intraoperative G-arm X-ray machine fluoroscopy times 7.19±2.198.Conclusion:1.The treatment of single-segment sequestered lumbar disc herniation through the TESSYS technology modified by percutaneous transforaminal endoscopic discectomy and classic TESSYS technology can effectively alleviate the pain in waist and lower extremities,and improve the life immediatedly,which is one of the minimally invasive surgical methods for the treatment of sequestered lumbar disc herniation.2.The TESSYS technology modified by percutaneous transforaminal endoscopic discectomy and the classic TESSYS have the same surgical effect in the treatment of single-segment mild sequestered lumbar disc herniation,which can help alleviate the pain in waist and lower extremities,and improve the life,and there is no significant difference in postoperative efficacy between the two methods.3.The pain in waist and lower extremities can be alleviated and the life can be improved significantly after the treatment of single-segment highly sequestered lumbar disc herniation through the TESSYS technology modified by percutaneous transforaminal endoscopic discectomy,which is more effective,superior than the classic TESSYS technology in the short term effects of the surgery,and is one of the minimally invasive surgical methods for the treatment of highly sequestered lumbar disc herniation. |
PDF Full Text Request