Efficacy of percutaneous endoscopic lumbar discectomy combined with lumbar epidural block in the treatment of patients with lumbar disc herniation

Abstract

Objective To observe the curative effects of percutaneous endoscopic lumbar discectomy (PELD) combined with lumbar epidural block in the treatment of patients with lumbar disc herniation (LDH). Methods Two hundred patients of both sexes with LDH, admitted to the Affiliated Hospital of Binzhou Medical College during the period from January 2017 to January 2018, were selected. One hundred patients were selected from the wards of spinal surgery department as the transforaminal endoscopic group, the other one hundred patients from the department of pain medicine as the PELD combined epidural group. Patients were treated with PELD alone in the former group, while patients were treated with PELD combined with lumbar epidural block with triamcinolone acetonide, lidocaine and mecobalamin in the latter group. Visual analogue scale (VAS), Oswestry disability index (ODI) were recorded at 1 week, 3 months and 6 months after the operation. Clinical efficacy was evaluated at 6 months after the operation. Results Compared with pre-operation, VAS was decreased at each time point after the operation in the two groups (P<0.05). VAS was significantly lower at 1 week, 3 months after the operation in the PELD combined epidural group than that in the only PELD group (P<0.05). Compared with pre-operation, ODI sub-items and total items were decreased at each time point after the operation in the two groups (P<0.05). ODI sub-items and total items were significantly even lower at 3 months after the operation in the combined epidural group than that in the transforaminal endoscopic group (P<0.05). There was no difference in the excellent rate and the effective rate at 6 months after the operation between the two groups (96% vs. 94%, P=0.060; 98% vs. 95%, P=0.442). Conclusion PELD combined with lumbar epidural nerve block can relieve pain and promote lumbar function recovery in the near stage, and accelerate the rehabilitation process for patients with LDH. Key words: Lumbar vertebrae; Intervertebral disc displacement; Endoscopy; Surgical procedure, minimally invasive; Anesthesia, epidural; Treatment outcome