Clinical Effect Of Percutaneous Transforaminal Endoscopic Discectomy In Treatment Of Recurrent Lumbar Disc Herniation

Objective: To observe the clinical effect of percutaneous foraminal endoscopy on postoperative recurrence of lumbar intervertebral disc herniation.Methods: A retrospective study was conducted on the relevant clinical data of45 patients with postoperative recurrence of lumbar disc herniation admitted to our hospital from May,2017 to December,2019.All patients were treated with percutaneous foraminal surgery,and indexes such as operation time,intraoperative blood loss,hospitalization cost and postoperative complications were recorded.Preoperative and postoperative indicators were compared using visual analogue scale(VAS),Japanese Orthopaedic Association Scores(JOA),and modified Mac Nab.To evaluate the clinical efficacy of percutaneous foraminal endoscopy in the treatment of recurrent lumbar disc herniation by comparing the above indexes.Results: The operation time of patients was 30 ～45 min,with an average of 37.42±4.25 min.The intraoperative blood loss was5-10 ml,with an average of 6.4±1.35 ml.The hospitalization cost is 13,000 to18,000 yuan,with an average of 15300± 1,400 yuan;The length of hospital stay was 2 ～ 6 days,with an average of 3.3±0.90 days.One patient had recurrent lumbar disc herniation after surgery,and the symptoms were significantly improved after repeated percutaneous foraminal surgery.None of the 45 patients had complications such as nerve root injury or lumbar infection,which were better than traditional open surgery in the treatment of recurrent lumbar disc herniation.By comparing the VAS scores before and after surgery,2.48±0.99 at1 week postoperatively and 1.22±0.86 at 3 months postoperatively were significantly higher than those before surgery 6.14±1.49 with statistical difference(P<0.05);JOA score analysis also showed that 18.86±2.69 at 1 week and 24.20±1.54 at 3 months postoperatively were significantly improved compared with 13.26±3.13 preoperatively,with statistical significance(P<0.05);The VAS and JOA scores at 1 year postoperatively were not significantly different from those at 3 months postoperatively(P>0.05);Compared with preoperative improvement rates,the JOA scores of patients at 1 week,3 months and 1 year were 71%,76.78% and 81.19% respectively.Based on the modified Mac Nab evaluation criteria,the excellent and good rate of surgical outcomes was 93.3%.Conclusions: Percutaneous foraminal endoscopic treatment of recurrent lumbar disc herniation has the advantages of less trauma,low cost,quick postoperative recovery and less complications,and has good clinical efficacy,which is worthy of clinical application and promotion.