| Objective:The clinical effects of intervertebral disc herniation with Modic I change and without Modic change were treated by means of intervertebral foraminoscopy,and the effect of endplate Modic I change on the effect of intervertebral foraminoscopy on lumbar disc herniation patients with lower back pain.Methods:A total of 684 cases of lumbar intervertebral disc herniation in patients with lumbar intervertebral disc herniation admitted in the Department of spine of Affiliated Hospital of Tai'an Medical College from the beginning of June 2013 to three years before and after June 2016 were studied,and 212 cases were selected.The MRI and X ray(positive lateral)examination of the lumbar spine,the MRI examination and the segment of Modic type I endplate change were all accepted after admission.The data collected were divided into two groups,namely,A group with endplate Modic I type change,age 31~67 years old,average 42 years old,104 cases,B group without end plate Modic change,age 32~66 years,mean 51 years,108 cases,two groups of patients underwent percutaneous transforaminal nucleus extirpation.The general data and imaging data of two groups of patients were recorded.The average improvement rate of VAS and ODI scores of lumbago and leg pain were calculated by pain visual analogue scale(VAS)and Oswestry dysfunction index(ODI).The results of two groups of patients received surgical treatment were evaluated by SPSS 22 software.Results:All patients were followed up with the shortest follow-up period of 12 months,the longest for up to 3 years and an average length of 1.9 years.There was no significant difference in low back pain and VAS and ODI scores in A and B two groups before operation(P>0.05).First days after the operation,the symptoms of lower extremity radiation pain were relieved or completely eliminated in the two groups.The symptoms of low back pain in the two groups were relieved,the VAS score and the ODI score of the low back pain were lower than the preoperative ODI and VAS scores.The two groups were statistically significant compared with the preoperative differences(P<0.05),the VAS score of the waist pain and ODI score in the group A patients.Compared with the B group,the A group was less than the B group,and there was a statistical difference between the two groups(P<0.05).The leg pain symptoms of the two groups were relieved at 3 days after the operation,the VAS score and the ODI score of the leg pain were lower than those before the operation.The two groups were significantly different from the preoperative VAS and ODI scores(P<0.05),and there was no significant difference between the two groups(P>0.05): in March,June and December after operation,the VAS score of lumbar pain and ODI score in group A were all better than those in group B,and the improvement rate of low back pain was worse than that in B group.The difference of low back pain improvement rate was statistically significant(P<0.05).The improvement rate of leg pain in groups of A and B two were not statistically significant(P>0.05)after operation in March,June and December.The recurrence rate was 8.6% in group A and 2.1% in group B,and the difference between the two groups was statistically significant(P< 0.05).Conclusions:1.Percutaneous discectomy is ideal for relieving lumbago and leg pain in patients with lumbar disc herniation.2.For patients with lumbar intervertebral disc herniation with endplate Modic I change,the degree of postoperative low back pain in some patients is less than that of those without Modic,and the recurrence rate of lower back pain is high.The possible cause is the disc derived lumbago of intervertebral disc caused by the Modic type I changed end plate. |
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