Study on the effect of microendoscopy discectomy and percutaneous transforaminal endoscopic discectomy on patients with lumbar disc herniation and its complications

Abstract

Objective To investigate the effect of microendoscopy discectomy(MED) and percutaneous transforaminal endoscopic discectomy(PTED) on the treatment of patients with lumbar disc herniation and its complications. Methods A retrospective study was performed on a total of 112 patients with lumbar disc herniation admitted from June 2017 to December 2018.According to different surgical methods, the patients were divided into the MED group and the PTED group, with 56 cases in each group.In the MED group, 36 males and 20 females were aged(56.34±5.23) years old, ranging from 24 to 78 years old.In the PTED group, 37 males and 19 females were aged(56.88±5.22) years old, ranging from 25 to 79 years old.Compare two groups of surgery, surgery in patients with preoperative and postoperative 7 days, 1 month, 2 months after operation, postoperative 3 months after two groups of patients with the Japanese orthopaedic association assessment score(JOA) treatment, postoperative complications, preoperative and postoperative 7 days two groups of patients with visual analogue score (VAS), 3 months, 6 months after disease recurrence. Results The operative time[(61.24±4.23) min] of the PTED group was longer than that of the MED group[(54.53±3.16) min], the operative incision length[(7.20±0.20) mm] of the PTED group was shorter than that of the MED group[(18.45±2.45) mm], the intraoperative blood loss[(25.34±4.35) ml] of the PTED group was lower than that of the MED group[(87.45±4.53) ml], and the postoperative field activity time[(3.45±0.41) d] of the PTED group was shorter than that of the MED group[(7.12±0.34) d], and the differences were statistically significant(P 0.05). There was no significant difference in JOA scores between the two groups before and 7 days after surgery, 1 month after surgery, 2 months after surgery and 3 months after surgery(P>0.05). Comparison of VAS scores between the two groups before operation showed no statistically significant difference(P>0.05). Postoperative VAS score of 7 days in PTED group(2.54±0.18) was better than that of MED group(3.45±0.24), and the difference was statistically significant(P 0.05). There was no statistically significant difference in disease recurrence rate between the two groups 3 months and 6 months after surgery(P>0.05). Conclusion MED and PTED in treatment of lumbar intervertebral disc protrusion has significant clinical effect, MED has a shorter time than PTED, PTED has less trauma, pain, patients recover quickly, two kinds of surgical complications and recurrence rates are low, high security, PTED better application effect in patients with lumbar disc prolapse, more widely, clinical ability according to patients condition, leading doctors surgery, hospital medical level choose the surgical methods and instruments. Key words: Lumbar disc herniation; Percutaneous transforaminal endoscopic discectomy; Microendoscopic discectomy; The recurrence rate