| Objective:Based on the theory of activity union,by comparing the pure between vertebral plate enlarge windowing excision of nucleus pulposus and two operation Waveflex half rigid internal fixation using the curative effect of treatment of adolescent single segmental lumbar intervertebral disc protrusion,retrospective study two kinds of schemes for postoperative lumbar segmental stability,mobility,the degree of intervertebral disc degeneration and the influence of patient evaluation and so on,It provides reference for clinical diagnosis and treatment in the future.Methods:A total of 40 adolescent patients with single-segment lumbar disc herniation who underwent simple interlaminar dilated fenestration and Waveflex semi-rigid internal fixation in The Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2016 to October 2021 were collected and screened.They were divided into 2groups,20 of whom were in the nucleus pulpotomy group.Twenty cases were semi-rigid fixation group.Basic data of the two groups were collected,including age,sex and course of disease.Intraoperative evaluation data,including operative time and blood loss;Quantitative score evaluation data included visual analogue scale(VAS)for pain and numbness,Oswestry Lumbar Spine Dysfunction Index(ODI),and Japanese Orthopaedic Society Score(JOA)at preoperative,1 month postoperative,and last follow-up.Imaging data included preoperative and last follow-up intervertebral disc height(DSH),foraminal height(HIF),intervertebral range of motion(ROM),and Pfirrmann degree of disc degeneration.The above data were statistically processed,and the clinical efficacy of the two schemes was analyzed by comprehensive comparison.Results:There was no statistical difference in basic data between the semi-rigid fixation group and the nucleus pulposus excision group(P>0.05).There were significant differences in intraoperative evaluation data between the two groups(P<0.01).The operation time and blood loss in the semi-rigid fixation group were longer than those in the nucleus pulposus excision group.In comparison of quantitative score evaluation data,there was no statistical difference between the two groups before and 1 month after surgery(P>0.05),but there was significant statistical difference between the two groups before and 1 month after surgery(P<0.01).The VAS score and ODI index in the nucleus pulposus removal group at 1 month after surgery were lower than those before surgery,while the JOA score was higher than that before surgery.The VAS score and ODI index in the semi-rigid fixation group at 1 month after surgery were lower than those before surgery,while the JOA score was higher than that before surgery.The statistical comparison between the last follow-up and 1 month after surgery showed significant differences(P<0.01).The VAS score and ODI index at the last follow-up of the nucleus pulpotomy group were lower than 1 month after surgery,while the JOA score was higher than 1 month after surgery.VAS score and ODI index in the semi-rigid fixation group at the last follow-up were lower than 1 month after operation,while JOA score was higher than 1 month after operation.There were significant differences between the two groups at the last follow-up(P<0.01).VAS score and ODI index in the nuclear pulpotomy group were higher than those in the semi-rigid fixation group,while JOA score was lower than those in the semi-rigid fixation group.In comparison of imaging data,there was no statistical difference between groups before surgery(P>0.05),but there was significant difference between groups at the last follow-up(P<0.01).Among them,DSH and HIF increased in the semimontium internal fixation group at the last follow-up,ROM and Pfirrmann grade decreased in the last follow-up,DSH and HIF decreased in the nucleus pulposus removal group at the last follow-up,ROM and Pfirrmann grade increased in the last follow-up.There was significant difference in the last follow-up between the two groups(P<0.01).DSH and HIF in the semi-rigid fixation group were higher than those in the nucleus pulposus excision group,while ROM and Pfirrmann were lower than those in the nucleus pulposus excision group.Conclusion:1.The operation time and intraoperative blood loss of semi-rigid fixation were greater than that of nuclear pulpotomy,which was related to the complexity of the operation of Waveflex semi-rigid internal fixation,the placement and stripping of Waveflex semi-rigid internal fixation system,the way and scope of exposure,and the surgical damage was larger;2 and a half just fixed and removal of nucleus pulposus group has therapeutic effect for lumbar intervertebral disc protrusion,short-term clinical curative effect of two kinds of operation method,and a half just fixed long-term clinical efficacy is superior to the removal of nucleus pulposus group,responsible in maintaining the segmental stability and provide a certain activity,slow down the amount of intervertebral disc degeneration and patient assessment of performance is satisfactory. |
PDF Full Text Request