Comparative Study on Percutaneous Transforaminal Nucleus Pulposus and Small Incision Interlaminar Nucleus Pulposus Extraction for Lumbar Disc Herniation
HOU Huibao, ZHANG Liren, LI Guoqiang, et al
Suzhou Municiple Hospital, Anhui Suzhou 234000, China
Abstract:Objective: To compare the clinical value of percutaneous transforaminal nucleus pulposus and small incision interlaminar nucleus pulposus removal for lumbar disc herniation (LDH). Methods: 60 patients with LDH in our hospital from November 2016 to February 2018 were enrolled. Percutaneous transforaminal nucleus pulposus removal was divided into intervertebral foramen. The nucleus pulposus extraction was divided into small incision groups, 30 cases in each group. The operation and postoperative complications were compared between the two groups. The follow-up to 6 months after surgery, the efficacy and functional improvement of the two groups were compared [Oswestry dysfunction index (ODI), Japanese orthopedic surgery score (JOA)] and quality of life (SF-36) score were counted. Results: Surgery and postoperative recovery: The length of the incision in the intervertebral foramen group, the time of surgery, the time of bed rest and the length of hospital stay were shorter than that of the small incision group. The amount of surgical bleeding and discectomy was less than that of the small incision group (P<0.05). Postoperative complications: The incidence of postoperative complications in the vertebral foramen group was 6.67% (2/30), which was lower than that in the small incision group (26.67% (8/30) (P<0.05); Surgical efficacy: The excellent and good rate of surgery in the intervertebral foramen group was 86.67% (26/30), and there was no significant difference between the small incision group and 83.33% (25/30) (P>0.05). Functional improvement: postoperative 6 The ODI index and JOA score of the intervertebral foramen and small incision group were improved compared with those before operation (P<0.05), but there was no significant difference between the two groups (P>0.05). Quality of life: postoperative At 6 months, the SF-36 scores of the intervertebral foramen group and the small incision group were higher than those before the operation, and the intervertebral foramen group was higher than the small incision group (P<0.05). Conclusion: Percutaneous transforaminal nucleus pulposus and small incision interlaminar nucleus pulposus extraction for LDH can achieve significant surgical results, improve patient dysfunction and improve lumbar function, but the former is more than the latter. The advantages of minimally invasive surgery, small trauma and quick recovery after surgery are more conducive to improving the quality of life of patients after surgery.