Clinical Study Of Percutaneous Transforaminal Endoscopic Discectomy For The Treatment Of Lumbar Disc Herniation As Day Surgery

Objective:Day surgery is a new mode of diagnosis and treatment in which patients undergo surgery and go to and out of hospital within a working day.With the advantages of small trauma,short operation time and quick recovery,percutaneous transforaminal endoscopic discectomy(PTED)has gradually become the first choice of surgery for lumbar disc herniation(LDH).At present,there are few reports about PTED for LDH as day surgery.This study analyzes the follow-up results of the PTED treatment LDH as day surgery mode and the general hospitalization mode to explore the safety and effectiveness of the PTED as day surgery mode for the treatment of LDH.Methods:A total of 183 patients with single-segment LDH who were admitted to the Department of Orthopedics of the Second Affiliated Hospital of Nanchang University from August 2013 to October 2015 were treated with PTED(general hospitalization group).From November 2015 to January 2017,261 patients with single-segment LDH underwent PTED in the day surgery center(day surgery group).These parameters were recorded such as the operation time,intraoperative complication,total hospitalization cost,the operation time,number of delayed discharge and readmission of the two groups of patients;The visual analog scale score(VAS)for leg and back pain,Oswestry Disability Index(ODI)score,and Macnab criteria were evaluated preoperatively and at 2 years postoperatively(final follow-up).Results:In the day surgery group,22 patients were delayed in discharge,and the delayed discharge rate was 9.36%.There was no significant difference in the average operation time,complication rate and readmission rate between the two groups.The average hospitalization time(19.2±0.9 h VS 2.8±1.1d)and the average hospitalization cost(24356 ± 126 yuan vs 28090 ± 286 yuan)in the day surgery group weresignificantly better than those in the general hospitalization group,and the difference between the two groups was statistically significant(P < 0.05).Within the group,the VAS score and ODI score in the last follow-up of the two groups were better than those before operation(P < 0.05);there was no significant difference between the two groups in the VAS score and ODI score in the last follow-up(P > 0.05).At the last follow-up,the excellent and good rate of the general inpatient group was 91.0%,and that of the daytime operation group was 89.8%.There was no significant difference between the two groups(P > 0.05).Conclusion:PTED for LDH is safe and effective as day surgery,which can significantly reduce the length of hospitalization and the cost of hospitalization.It is worth promoting and applying in clinical work in the future.