The Study Of "Jetting Suture" Under The Microendoscopic Discectomy Surgery In Treatment Of Lumbar Disc Herniation

Objective:To study the clinical effect of the newly designed "jetting suture"technique in annular repair under microendoscopic discectomy(MED).Methods:The cases included in the experimental study were 80 patients who received MED at Qilu Hospital of Shandong University from July 5,2013 to March 8,2017.Divided into two groups according to whether or not an annular fibulous suture,the control group(A n=40)and the experimental group(B n=40).Record the surgical time and blood loss of the surgical patients and compare the differences between the two groups.During the follow-up period,record the JOA scores,ODI scores,and VAS scores of the surgical patients before,1 month,and 2 years after the operation and assess clinical effects.Results:There were no significant differences in general indicators such as age,gender,surgical segment,and preoperative score between the two groups of patients in group A and group B(P>0.05).The average age of patients was 35.6 years(18-62 years).The average operation time in group A was 98.2.4±24.3 minutes,and the blood loss was 44.8±10.8 mL.The average operation time in group B was 102.3±23.2 minutes,and the blood loss was 45.3±11.5mL.There was no difference in operation time and blood loss between the two groups(p>0.05).After treatment,the ODI score of group A improved from 73.69 ± 10.56 to 9.43±2.35 before operation,and the JOA increased from 7.4±1.9 to 26.9±2.2.The improvement rate of JOA was 29 cases and good in 11 cases.The ODI score of group B improved from 73.52±10.18 before surgery to(9.62±2.21),and the JOA improved from(7.2±2.2)to(27.1±2.3).The improvement rate of JOA was 31 cases and good 9 cases.The preoperative VAS scores of the two groups were A group(7.1±2.3)points,B group(7.2±2.1)points,2 years after operation(0.54±0.47)points,and B group(0.52±0.43)points.The ODI,JOA,and VAS scores of the two groups at 1 and 2 years after surgery were significantly different from the preoperative scores(p<0.05).There was no statistical difference between the two groups at the same time point(p>0.05).A case of recurrence occurred in group A,and there was no statistical difference in the recurrence rate between the two groups.Two patients in group A and 4 patients in group B had abnormal feeling of the innervation area after operation.After the nutritional nerve,hormone and dehydration treatment,the symptoms improved for hours.Considering the symptoms related to intraoperative local stimulation.Conclusion:This study shows that the "jetting suture.technique can be safely performed during surgery.Considering the efficacy of the annular fibulous repair,the"jetting suture" technique for the prevention of relapse in LDH is safe,effective and worthy of promotion.