Effect of combination of lateral recess decompression by Tessys technique and PTED in patients suffering from contralateral symptoms of lumbar disc herniation

Abstract

The aim was to explore the effect of lateral recess decompression by percutaneous transforaminal endoscopic spine system (Tessys) technique combined with percutaneous transforaminal endoscopic discectomy (PTED) on pain medium, nerve function and stress response in patients suffering from contralateral symptoms of lumbar disc herniation. A total of 96 patients with contralateral symptoms of lumbar disc herniation treated in our hospital from February 2015 to April 2017 were randomly divided into control group and study group, with 48 cases in each group. The control group underwent PTED, and the study group underwent lateral recess decompression by Tessys technique combined with PTED. The visual analogue scale (VSA) score and Japanese Orthopaedic Association (JOA) score before surgery and 3 months after surgery were compared between the two groups. The levels of serum pain medium (prostaglandin E2 (PGE2), histamine (HA), 5-hydroxytryptamine (5-HT)) and oxidative stress indexes (malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD), total antioxidant capacity (TAC)) before surgery and 7 days after surgery were compared. The clinical efficacy of the two groups was compared at 1 month after treatment. One month after treatment, the excellent and good rate in the study group was significantly higher than that in the control group (85.4% vs 56.3%; P < 0.05). There was no significant difference between VAS and JOA score in the two groups preoperatively ( P > 0.05). At 3 months after surgery, the VAS score in the study group was significantly lower than that in the control group ( P < 0.05), and the JOA score in the study group was significantly higher than that in the control group ( P < 0.05). There was no significant difference in serum PGE2, HA and 5-HT levels between the two groups preoperatively ( P > 0.05). At 7 days after surgery, the serum PGE2, HA and 5-HT levels in the study group were significantly lower than those in the control group ( P < 0.05). Preoperatively, the levels of serum MDA, MPO, SOD and TAC were not significantly different between the two groups ( P > 0.05). On the seventh day after surgery, the levels of serum MDA and MPO in the study group were significantly lower than those in the control group ( P < 0.05), and the levels of SOD and TAC were significantly higher than those in the control group ( P < 0.05). In conclusion, the combined therapy of lateral recess decompression by Tessys technique and PTED in patients suffering from contralateral symptoms of lumbar disc herniation has a definite clinical effect, which can significantly alleviate the symptoms of low back pain and motor nerve function and reduce the contents of serum pain medium and the levels of oxidative stress. It is worthy of clinical promotion.