| ObjectiveThe purpose of this study is to discuss the comparison between the Modified BEIS Surgical Technique and BEIS Surgical Technique in the treatment of underarm lumbar disc herniation,and to analyze the VAS score and ODI dysfunction score of patients before and after surgery,so as to provide a new idea and operation method for clinicians in the treatment of this type of disease.MethodsFrom July 2016 to July 2018,54 cases of subaxillary lumbar disc herniation were treated by percutaneous spinal endoscopy via transfrominal approach.According to the admission ordinal number,the patients with singular ordinal number are divided into two groups,and the patients with even ordinal number are divided into group A(BEIS Surgical Technique group)and group B(full endoscopic transforaminal approach technology group).Germany maxMore spinal endoscopy system was used in both groups.In group A,the transforaminal approach was used.After TOM shidi was guided to the target,the articular process was formed with a safety bone drill,and the working cannula and endoscope were inserted.In group B,the working sleeve was inserted after the puncture and soft tissue expansion were completed,and the articular process was formed under the endoscope with the osteotome under the endoscope.The following operations were the same in the two groups: exposing the three layers of tissues of ligamentum flavum,nerve dural sac and posterior longitudinal ligament,then performing the removal of ventral nucleus pulposus and the release of nerve root duralsac.The operation time,fluoroscopy times,preoperative and postoperative visual analogue scale(VAS)and Oswestry disability index(ODI)were used for evaluation and comparison between the two groups ResultsAll patients successfully completed the operation with an average operation time(minutes): group A(72.93±5.12)and group B(55.56±3.48).Group A was significantly shorter than group B,with significant statistical significance(p<0.01).The times of fluoroscopy in operation were: group A(17.44±1.13)and group B(5.15±0.28).Group A was significantly less than group B,with significant statistical significance(p<0.01).In group A,there were two cases of nerve adventitia contusion and one case of cerebrospinal fluid leakage during the operation.There were no obvious symptoms after the operation.In group B,there were no complications during the operation.The average follow-up time was 12.6 months(6 ~ 29 months).VAS score of lower limb pain before operation was(6.37 ± 0.19)in group A and(6.04 ± 0.18)in group B.VAS score 3 months after operation: group A(1.48±0.94)and group B(1.67±1.04)before operation.Six months after operation,there was no statistical difference between group A(1.48±0.18)and group B(1.15±0.14)(p>0.05).VAS scores at different follow-up time points after operation in both groups were significantly improved compared with those before operation(p<0.01).ODI index(%)before operation: group A(53.26±15.53)and group B(50.93±13.55).There was no statistical difference between the two groups(p>0.05).ODI index(%)at 3 months after operation: group A(13.11±7.55),group B(14.96±5.99)and 6 months after operation were(11.93±7.02),(12.07±7.10),respectively.there was no statistical difference between the two groups(p>0.05).The ODI score of the two groups at different follow-up time points after operation was significantly improved compared with that before operation(p<0.01).ConclusionsCompared with BEIS technique,the full endoscopic transforaminal approach for axillary lumbar disc herniation has no obvious difference in therapeutic effect,but has obvious advantages in the number of fluoroscopy and the operation time. |
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