| Purpose:To explore the curative effect of the preoperatively and the curative effect of the different iliac crest height through the intervertebral foramen endoscopy through the clinical observation of the patients with L5/S1 disc herniation with different iliac crest height and intervertebral foramen endoscopy.Methods: The clinical data of 60 patients with L5/S1 disc herniation treated by endoscopy in the Second Affiliated Hospital of Hunan University of Chinese Medicine from December 2015 to December 2017 were collected.Referring to the clinical experience of Lee S and Halldin K,and combining with the clinical experience of the tutor,the relationsh ip between the highest point of the iliac crest line and the L4 and L5 pedicle is measured by the X-ray film of the anterior lumbar lateral position.It is divided into two groups: the A group(the low iliac crest): the highest point of the iliac crest bel ow the upper margin of the pedicle of the L5 vertebra,a total of 30 cases,the high iliac crest group(the high iliac crest): the highest level of the iliac crest(the high iliac crest).The upper edge of the root of the arch was above 30 cases.The opera tion time,intraoperative bleeding volume,complications(dural tear,nerve injury,nucleus pulposus residual decompression,intraoperative pain intolerance,and so on)were compared between the two groups and the therapeutic indexes were compared before a nd after operation,1h after operation,VAS in March after operation,and the OD I score of March before and after operation.The patients in the two groups of A and B were randomly divided into the treatment group and the control group.The treatment group was treated with myosa powder combined with local anesthesia and intervertebral endoscopy under local anesthesia in 15 cases,and the control group was treated with endoscopy under the simple local anesthesia,15 cases were treated by endoscopy under the simple local anesthesia.The changes of FRS score(anaesthesia pain)in each group were observed.All the drugs in Maji powder and flavour prescription were provided by the Chinese medicine room of the Second Affiliated Hospital of Hunan University of Chinese Medicine and two bags of 100 milliliters,which were divided into two times in the morning and evening.The average of 2~3 days from the second days to the day of the operation.Results:All the operations were successfully completed.There were statistically significant differences between the two groups of operation time and intraoperative fluoroscopy(P<0.05).The probability of complications in the two groups occurred: 1 cases of dural tear in group A and 1 cases of residual decompression of nu cleus pulposus,1 cases of nerve injury in group B,1 cases of dura meninges,1 cases of intraoperative pain intolerance,and no residual decompression of nucleus pulposus.Complete 3 cases.There was no statistically significant difference between the two groups at the same time point VAS score and ODI score,and the difference was statistically significant(P<0.05)in the two groups after operation 1H,VAS score in March,ODI score after operation and preoperative VAS score(P<0.05),and FRS in the treatm ent group in the A group(low iliac crest)and B group(high iliac crest).Compared with the control group,the difference was statistically significant(P<0.05).Conclusion:1.the preoperative adjuvant treatment of L5/S1 LDH through intervertebral foramen e ndoscopy with different iliac crest heights is a good analgesic effect,and 2.the intervertebral endoscopy is feasible and satisfactory for the treatment of L5/S1 disc herniation with different iliac crest heights;3.the height of the iliac crest and the intervertebral foramina approach There is a correlation between the feasibility of endoscopic treatment of L5/S1 disc herniation.When the highest point of the iliac crest is above the upper edge of the L5 vertebral arch,the time of surgery is prolonged,the number of radiation in the operation is significantly increased,and the complications are significantly increased. |
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