Curative effect observation on fenestration discectomy for lumbar disc herniation with different pathological types

Abstract

Objective To explore the effect of discectomy for different pathological typings of lumbar disc herniations.Methods 98 patients with lumbar disc herniations treated by discectomy were retrospectively analyzed.They were divided into four types by the nucleus pulposus shape and the size of fibrous rings breakage in the intraoperative findings,and to explore the effect of every type after 3 months.All results were analyzed statistically.Results Preoperative and postoperative JOA scores showed that backache,skelalgia,gait,daily activity limitation and the total scores were significantly different in all types (P ＜ 0.01).Except for type Ⅰ,backache and straight-leg raising test got significant differences in all types (P ＜ 0.01).Except for type Ⅳ,sensory,motility and bladder dysfunction were not significantly different in all types (P ＞0.05).Postoperative VAS scores of each type were significantly lower than preoperative VAS scores (P ＜ 0.01).The therapeutic effects were ranked by SC criterion such as type Ⅳ ＞type]Ⅱ ＞type Ⅲ ＞type Ⅰ.Conclusion After fenestration discectomy,backache,gait,skelalgia and the total scores of patients with lumbar disc herniation significantly improved,with good clinical effect.Prognosis was related to preoperative completeness of annulus fibrosus of intervertebral disc. Key words: Open; Discectomy; Lumbar disc herniation; Pathological typing; JOA; VAS; SC