Clinical Study Of Curative Effect Of Tessys And Transforaminal Kirs-wire Guiding External Trephination Under Endoscopy (ET) On Treatment Of Lumbar Disc Herniation

Purpose:To investigate the curative effect and summarize surgical experience in the treatment of lumbar intervertebral disc herniation with transforaminal endoscopic spine system(TESSYS)and transforaminal kirs-wire guiding external trephination under endoscopy(ET).Methods:From January 2016 to December 2017,a retrospective analysis was carried out on 57 patients with LDH(lumbar intervertebral disc herniation)who underwent TESSYS or ET.The patients were divided into TESSYS(34 cases)and ET group(23 cases).We recorded and analyzed the clinical data of patients,including Intraoperative fluoroscopy times,the operation duration,intraoperative blood loss,visual analogue scale(at 48 hours,3 months,6 months postoperation),the oswestry disability index(at48hour,3months,6months,12 months postoperation)and modified Macnab classification(3,6month postoperation).Results:All surgeries were carried out successfully without permanent nerve root injury.One patient in TESSYS group had no significant pain alleviation on the first day postoperation,but after conservative therapy,the symptom was relieved..The patients in ET group had fewer intraoperative fluoroscopy times and less operation time than TESSYS group,and the difference was statistically significant(P<0.05).However,in intraoperative blood loss,there was no significant difference between the 2 groups(P>0.05).All of the 57 cases were followed up for at least 6 months after surgery.The VAS and ODI(at postoperative 48 hours,3 months,6 months)of the 2 groups were all obviously lower than the preoperative one and the statistical differences were significant(P<0.05)Between TESSYS group and ET group,the VAS and ODI(at postoperative 48 hour,3month,6month)were not significantly different(P>0.05).There was no significant difference between the 2 groups in modified Macnab classification at 3 months and 6 months after operation.Conclusions:1.Both TESSYS and ET have advantages of less bleeding,faster recovery and better curative effect in the treatment of L5/S1 LDH.2.ET has simpler operative procedure,shorter operation time and less fluoroscopy times than TESSYS.