Comparing Clinical Outcome Of Paraspinal Mini-tubular Microdiscectomy Versus Percutaneous Transforaminal Endoscopic Discectomy For Lumbar Disk Herniation

Objective: To compare the efficacy of Paraspinal Mini-Tubular Microdiscectomy(PMTM)and Percutaneous Transforaminal Endoscopic Discectomy(PTED)in treatment of single segment lumbar disc herniation(LDH).Method: In this retrospective study,61 cases with single segment LDH from November 2017 to August 2018 were collected.All patients were diagnosed with single segment LDH by clinical manifestations and imaging data,and conservative treatment was ineffective.All cases were divided into two groups according to different surgical methods:32 patients peformed PMTM and 29 patients performed PTED.Visual analogue scale(VAS),Japanese Orthopaedic Association(JOA)Scores,Oswestry disability index(ODI)were recorded preoperative and postoperation 1 week,1 month,3 months,6 months.In addition,operation duration,intraoperative blood loss,incision length,postoperative hospitalization days and complications were combined to evaluate the operation effect.Result: There was no significant difference in gender,age,preoperative VAS score,ODI score and JOA score between the two groups(P>0.05).VAS score,ODI score and JOA score scores of two groups were improved after operation significantly(P<0.05),but there were not significant differences statistically in comparison between two groups(P<0.05).All patients were operated successfully.PTED group is less than PMTM group in operation duration,incision length and postoperative hospitalization days,the comparison was statistically significant(P<0.01).There was no significant difference between the two groups in the amount of intraoperative bleeding and the incidence of postoperative complications(P>0.05).Conclusion: PMTM and PTED can effectively treat single segment LDH.There is no significant difference in short-term clinical efficacy between the two methods.The operation space of PMTM is larger than PMTM,and PMTM can adapt to complex conditions.PTED has shorter incision length and operation time and shorter hospital stay after operation,but its advantages are not obvious.PTED has long learning curve,high requirement for operation and limitation of indication.Generally speaking,both of them have their own advantages.They should be selected according to the specific conditions of the disease and the experience of the surgeon.Due to the small number of cases in this study and the short follow-up time,a large number of complete follow-up data and RCT studies are needed to further explore the medium and long-term efficacy of the two methods.