Application Of Endoscope-Guided Row Saw Technique In Percutaneous Endoscopic Lumbar Discectomy For Intervertebral Foramina

Objective: To investigate the feasibility,clinical effect and value of application of endoscope-guided row saw technique in percutaneous endoscopic lumbar discectomy.Method: A retrospective study was conducted in 60 patients with LDH treated by percutaneous endoscopic lumbar discectomy in the Department of Orthopedics and Spine of our hospital from September 2018 to September 2020.Among them,34cases(experimental group)received endoscopic-guided row saw for the formation of intervertebral foramen and 26 cases(control group)received the classic TESSYS technology.The modified Mac Nab efficacy evaluation criteria were adopted by comparing the operation time,the times of intraoperative X-ray fluoroscopy and the occurrence of complications in the two groups.The postoperative recovery is evaluated using the ODI dysfunction scale,while the pain visual analogue scale(VAS)was used to assess the pain in the waist and legs before the operation,one day after the operation,three months after the operation,six months after the operation and at the last follow-up.Result: Compared with the classic TESSYS technique(control group),the times of X-ray fluoroscopy and operation time in the experimental group are better than those in the control group(P<0.05).The VAS scores and ODI dysfunction index scores recorded in the first day,three months,six months after operation and the last follow-up were significantly lower than those before operation(P < 0.05).However,there is no significant difference between two groups at the same follow-up time point(P>0.05).At the same time,there was no significant difference between the two groups in evaluating the excellent and good rate of operation by modified Mac Nab(P>0.05).Conclusion:(1)Compared with the classical operation,the endoscope-guided row saw technique has the same clinical effect and is feasible in clinic.(2)Compared with the classical surgery,the endoscope-guided row saw technique has the advantages of less trauma to articular process,lower requirement of puncture target,lower radiation exposure,visualization,controllability and shorter operation time.