Comparison Of Short-term Clinical Effects Of Intervertebral Foramen Approach And Interlaminectomy Approach On Lumbar Disc Herniation With Lateral Recess Stenosis

Objective:The purpose of this study is to explore the difference of the clinical effect of the treatment of lumbar disc herniation with lateral recess stenosis by the intervertebral foramen approach and the laminectomy approach,so as to provide a reference for the selection of the clinical treatment of surgical methods.Methods:from November 2018 to December 2019,65 patients with prolapse of lumbar intervertebral disc and stenosis of lateral recess were analyzed.Among them,34 patients were operated through intervertebral fora men and 31 patients were operated through intervertebral foramen.The sex,age,operation time and times of intraoperative fluoroscopy of the two groups were recorded.At the same time,the patients were operated before,1 month after and 3 days after operation The visual analogue scale(VAS)and Oswestry dysfunction index(ODI)were improved.On the third day after operation,CT was reexamined,and the stenosis area of the upper side of the reexamined CT was measured by computer software before and after operation,and the stenosis area of the anterior and posterior side of the two groups were compared.The operation was performed by the same person,and the statistical data and evaluation were performed by the same person.Statistical data were analyzed by SPSS 21.0.Results:all the patients were followed up for 3 months.There was no significant difference in age,gender,VAS pain score and ODI dysfunction index score between the two groups(P>0.05).The VAS pain score and ODI dysfunction index score of the two groups were significantly lower than that of the two groups(P<0.05).The preoperative and postoperative stenosis area of the group through intervertebral foramen was 52.42±8.42mm~2 and 6.74±1.42mm~2,respectively.There was significant statistical difference between the two groups.The preoperative and postoperative stenosis area of the group through intervertebral foramen was 51.46±6.72mm~2and 6.88±1.38mm~2,respectively.There was significant statistical difference between the two groups.Compared with the group through the intervertebral foramen,the operation time was significantly shortened[(52.35±17.54)min vs(65.45±15.24)min,P<0.05],and the times of X-ray fluoroscopy were significantly reduced[(4.65±2.54)vs(11.65±6.48),P<0.05].Conclusion:both the transpedicular approach and the transpedicular approach are safe and effective methods for the treatment of lumbar disc herniation with lateral recess stenosis,and the short-term clinical effect is similar.The two groups of surgical approaches can be used under the microscope to expand the decompression of lateral recess with the tools of grinding and drilling,laminectomy and so on,and the decompression range is similar during the operation.Transpedicular approach can significantly shorten the operation time and reduce the times of intraoperative fluoroscopy.