An Analysis Of The Correlation Between Percutaneous Endoscopic Lumbar Discectomy For The Treatment Of Lumbar Disc Herniation And Lumbar Disc Degeneration

Lumbar disc herniation is one of the more common orthopedic diseases,is a common cause of lumbar leg pain,mainly because of lumbar disc degeneration,under the action of external factors,annular rupture,nucleus pulposus herniation or prolapse,stimulation or compression of nerve root produced by a series of clinical symptoms.The main clinical symptoms of LDH include pain in the lower back,pain in one lower limb or both lower limbs,numbness,walking difficulty,etc.Current treatment options for LDH include conservative(non-surgical)treatment and surgical treatment.The majority of patients can get relief of clinical symptoms and recovery of function after conservative treatment,but may relapse in the long term.Currently,there are many surgical methods of LDH,mainly traditional open surgery and minimally invasive surgery.With the continuous update of modern spinal endoscopy equipment,minimally invasive spinal surgery technology has developed rapidly.Compared with traditional open surgery,minimally invasive micro-endoscopic discectomy and Quadrant minimally invasive channel treatment of LDH,percutaneous endoscopic technology is a more minimally invasive spinal endoscopy technology.PELD,with its unique advantages of less trauma,less bleeding and no impact on the stability of the spine,has been widely recognized by doctors and patients and has become a new direction for minimally invasive treatment of LDH.Objective:Lumbar magnetic resonance imaging and Pfirrmann grades were used to obtain and analyze the related data of lumbar degeneration degree for case selection and grouping.Through the side way intervertebral foraminal endoscopic nucleus pulposus extraction treatment of lumbar disc herniation,and the follow-up analysis of its clinical effect,to explore the intervertebral foraminal endoscopic nucleus pulposus extraction treatment of lumbar disc herniation clinical effect and the correlation of lumbar degeneration degree.Methods:From June 2017 to December 2018,95 patients with single-segment lumbar disc herniation who were treated by intervertebral foraminal endoscopic nucleus pulposus extraction in affiliated hospital of chengde medical college were collected,followed up by questionnaire and telephone for 1 year and collected postoperative data,among which 4 patients had their contact information changed,and finally 91 patients were followed up completely.Among them,there were 50 males and 41 females.The age was 15-70 years,with an average age of(44.9±10.7)years.All patients underwent lumbar MRI to determine the responsible segment before surgery,including l2-3 in 2 cases,l3-4 in 5 cases,l4-5 in 47 cases,and L5/S1 in 37 cases.Grouped on MRI classification standard Pfirrmann intervertebral disc degeneration,Pfirrmann ? level group of 38 cases,? level group of 38 cases,? level group of 15 cases.Visual analogue scale(VAS),Oswestry disability index(ODI)and modified Macnab efficacy evaluation were recorded at preoperative,postoperative 7 days,3 months and 12 months,respectively.Results:1 The operation of all patients was completed by the same surgeon without any change of operation method or approach.VAS and ODI scores of 91 patients at each time node after surgery were lower than those before surgery,and the difference was statistically significant(P<0.05).2 There were significant differences in VAS and ODI scores of 1 month,3 months and 12 months in Pfirrmann group ?,? and ?,and in VAS and ODI scores of 3 months and 12 months in Pfirrmann group ? and ?,respectively(P < 0.05).According to the modified macnab standard,the excellent and good rates of the three groups were 97.36%(37 / 38),84.21%(32 / 38)and 60%(9 / 15),respectively.3 No complications such as intervertebral space infection,nerve root injury and retroperitoneal hematoma occurred in 91 patients.Conclusion:1 Percutaneous endoscopic lumbar discectomy has a significant clinical effect in the treatment of lumbar disc herniation.As a safe and effective minimally invasive technique,it is worthy of popularization and application.2 There is a correlation between the curative effect of Percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation and the degree of lumbar degeneration.The degree of lumbar degeneration before operation is one of the factors that affect the curative effect of intervertebral foramoscope.In this study,when pfirrmann grading to ? patients postoperative intervertebral foramen mirror of symptoms is ? level or ? level group is not obvious.For patients with Pfirrmann grade II or grade III lumbar disc herniation with definite surgical indications,it is suggested to use the technology of intervertebral foramen.