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| Effect of Discectomy via Iliac Crest Approach and Interlaminar Approach on Pain Function and Long-term Recurrence in Patients with L5S1 Disc Herniation |
| ZHU Bin, et al |
| Ethnic Hospital of Enshi Tujia and Miao Autonomous Prefecture, Hubei Enshi 445099, China |
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Abstract Objective: To investigate the effects of discectomy via iliac crest approach and interlaminar approach on pain, function and long-term recurrence of L5~S1 disc herniation. Methods: From January 2014 to August 2016, 82 patients with lumbar disc herniation who were treated in our hospital were randomly divided into observation group (39 cases) and control group (43 cases). They were treated discectomy via iliac crest approach and intervertebral approach, respectively, both groups were followed up for 24 months. The operation conditions, pain before and after operation (VAS), motor function (ODI score), complications and long-term recurrence after surgery between the two groups were compared. Results: There was no significant difference in the time of postoperative ambulation and average hospitalization between the two groups (P=0.838, 0.169). The operation time, fluoroscopy times and intraoperative bleeding volume in the observation group were significantly higher than those in the control group (P=0.000, 0.000, 0.039). The VAS scores in the lumbar and leg and ODI scores of the two groups were significantly lower than those before operation (P<0.05), The VAS score of the observation group at 3 and 24 months after operation was lower than that of the control group (Pwaist=0.008, 0.002, Pleg = 0.006, 0.001). There was no significant difference in the ODI score between the two groups (P = 0.553, 0.202). There was no significant difference in the incidence of postoperative complications between the two groups (12.82% vs. 18.60%, P=0.474). The recurrence situation was not statistically significant between the two groups(HR=0.531,95%CI[0.107, 2.634], P=0.457). Conclusion: Discectomy via iliac crest approach can significantly relieve pain, restore the activity of patients, and the safety is guaranteed. However, the operation time and fluoroscopy times need to be further optimized.
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2019, Vol. 25 
