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| The Effect of Percutaneous Transforaminal Endoscopic Technique on ODI Index and Pain Mediators in Elderly Patients with Free LDH |
| WANG Haibin, WANG Ying |
| Shaanxi Provincial People's Hospital, Shaanxi Xi'an 720000, China |
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Abstract Objective: To investigate the effect of percutaneous transforaminal endoscopic discectomy (PTED) on surgical efficacy, Oswestry dysfunction index (ODI), serum substance P (SP), prostaglandin E2 (PGE2), neuropeptide Y (NPY) and postoperative adverse events in elderly patients with free lumbar intervertebral disc herniation (M-LDH). Methods: The clinical data of 117 elderly M-LDH patients in our hospital from August 2018 to August 2020 were collected for retrospective analysis. According to the surgical plan, they were divided into a control group (n=58) and an observation group (n=59). The control group underwent mobile microendoscopic discectomy (MMED), and the observation group underwent PTED. The surgical efficacy, perioperative conditions, and postoperative adverse events of the two groups were observed, and the ODI index and pain degree (VAS score), serum SP, PGE2, NPY levels, and inflammatory stress index levels [tumor necrosis factor-α (TNF-α), matrix metalloproteinase-3 (MMP-3), malondialdehyde (MDA)] before and after the operation were compared. Results: The intraoperative blood loss of the observation group was less than that of the control group, and the operation time and the number of fluoroscopy were longer than those of the control group (P<0.05). Compared with the control group, the serum SP, PGE2 and NPY levels were lower in the observation group one month after the operation (P<0.05). Serum levels of TNF-α, MMP-3 and MDA in the observation group were lower than those in the control group on the 3rd day after operation (P<0.05). The VAS and ODI index scores of the observation group were lower than those of the control group at 1 month after operation (P<0.05). There was no significant difference in the incidence of adverse events and the excellent and good rate of surgery at 3 months after operation (P>0.05). Conclusion: PTED is a safe and effective measure for the treatment of elderly patients with M-LDH. It can further relieve inflammatory stress, reduce postoperative lumbar pain, and improve postoperative lumbar spine function. It is worthy of promotion.
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2021, Vol. 27 
