Transforaminal endoscopic minimally invasive operation and lumbar fenestration and decompression internal fixation in treatment of lumbar disc herniation: A clinical comparison

Abstract

Objective To compare the clinical effects of transforaminal endoscopic minimally invasive operation and lumbar fenestration and decompression internal fixation in the treatment of lumbar disc herniation. Methods Eighty-two patients with lumbar disc herniation, who were hospitalized in our hospital, were included as the subjects in the study and randomly divided into the control group and the study group (n=41 each) . The control group was treated with conventional lumbar fenestration and decompression internal fixation, and the study group was treated with transforaminal endoscopic minimally invasive operation. The changes of the operation indexes between the two groups were compared. The postoperative pain degree was evaluated by visual analogue scale (VAS) . The recovery of the daily living ability was evaluated by Oswestry disability index table (ODI) and the scoring standard of Japanese Orthopaedic Association (JOA) . At one year after the operation, the Macnab evaluation criteria of the surgical effect in low back pain was used to evaluate the efficacy in both groups. The incidence of complications was recorded. Results The operation time, incision length and length of hospital stay in the study group were shorter than those in the control group[ (75.65±15.12) min, (0.68±0.11) cm, (5.11±1.26) d vs (11.26±2.41) d, (6.26±0.47) cm, (300.26±11.26) ml], and the intraoperative blood loss was less than that in the control group [ (26.36±10.55) ml vs (126.81±5.74) min] (P 0.05) . At 48 h, 72 h and 96 h after the operation, the VAS scores in the two groups were lower than those at 24h after the operation (P<0.05) , whereas the VAS scores in the study group at different time points after the operation were lower than those in the control group[ (3.31±0.56) , (2.23±0.56) , (1.16±0.26) , (0.71±0.11) vs (5.36±1.22) , (4.75±0.54) , (3.24±0.37) , (2.21±0.36) ] (P<0.05) . The ODI scores in the study group at 3, 6 and 12 months after the operation were lower than those in the control group[ (18.22±2.11) , (10.23±1.77) , (5.22±1.56) vs (26.87±3.26) , (19.36±1.25) , (10.21±1.28) ], whereas the JOA scores were higher than those in the control group[ (12.35±2.47) , (20.36±1.78) , (26.12±1.33) vs (8.21±1.26) , (15.26±1.46) , (22.21±1.02) ] (P<0.05) . Conclusion Using transforaminal endoscopic minimally invasive operation in the treatment of lumbar disc herniation shows less surgical trauma, high total effective rate, rapid recovery rate, and significantly improved daily living ability in the patients. Key words: Intervertebral disk displacement; Diskectomy; Surgical procedures, minimally invasive