Risk Factors For The Efficacy Of Transforaminal Endoscopic Spine Surgery In The Treatment Of Lumbar Disc Herniation

Objective To explore the risk factors related to the efficacy of transforaminal spinal endoscopy in the treatment of lumbar disc herniation(LDH),and to provide a reference for clinical application.Methods The clinical data of 458 patients with LDH who underwent percutaneous endoscopic transforaminal discectomy(PETD)in the Department of Pain of the First Affiliated Hospital of Nanchang University from January 2016 to September 2018 were collected and organized.33 patients were excluded,and 425 patients with LDH were followed up for 1 year.The patients followed up were 257 male patients and 168 female patients,aged 16-79 years.The modified MacNab curative effect evaluation criteria were used to evaluate the curative effect of the surgery and grouped.The patients with modified MacNab evaluation standard excellent and good were group G(389 patients),and those with modified MacNab evaluation standard medium and poor were group B(36 patients).Chi-square test was used to perform single factor analysis on clinical parameters such as age,gender,BMI,smoking,history of lumbar trauma,course of the disease,whether radiculalgia merges back pain,segments,Pfirrmann classification,spinal canal morphology,protrusion calcification,and spondylolisthesis.Logistic regression analysis was performed for those factors that had statistical significance(P<0.05)in univariate analysis.Results The results of univariate analysis showed that the two groups of patients were not statistically significant in terms of gender,smoking history,lumbar trauma history,segment,and whether radiculalgia merges back pain(P>0.05);the two groups were compared in terms of BMI,age,course of disease,spinal canal shape,Pfirrmann classification,spondylolisthesis,and calcification of protrusions were statistically significant(P<0.05).Logistic multivariate analysis showed that patient age,spinal canal morphology,and Pfirrmann classification were not risk factors affecting the efficacy of PETD in the treatment of LDH(P>0.05),course of the disease(OR = 8.505,P = 0.002),BMI(OR = 7.334,P<0.001),spondylolisthesis(OR = 15.072,P = 0.001),protrusion calcification(OR=27.613,P<0.001)are the risk factors affecting the efficacy of PETD in the treatment of LDH.Conclusion BMI,age,course of disease,spinal canal morphology,Pfirrmann classification,spondylolisthesis,and calcification of protrusions are related to the efficacy of PETD in the treatment of LDH.The course of disease,BMI,spondylolisthesis and calcification of protrusions affect PETD in the treatment of LDH Independent risk factors for efficacy.