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| Comparison of Clinical Efficacy of Percutaneous Endoscopic Interlaminar Discectomy and Traditional Interlaminar Fenestration Discectomy for the Treatment of L5S1 Single-Segment Lumbar Disc Herniation |
| ZHANG Hui, LIU Shenpeng, SONG Kai, et al |
| The First Affiliated Hospital of Xinxiang Medical University, Henan Xinxiang 453100, China |
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Abstract Objective: To compare the clinical efficacy of percutaneous endoscopic interlaminar discectomy (PEID) and traditional interlaminar fenestration discectomy (FD) in the treatment of L5S1 single-segment lumbar disc herniation (LDH) patients.Methods: A retrospective analysis of 66 patients with L5S1 single-segment lumbar disc herniation who underwent percutaneous endoscopic interlaminar discectomy or traditional interlaminar fenestration discectomy from January 2018 to May 2019 were enrolled and divided into PEID group(35 cases)and FD group(31 cases)based on different surgical methods. Local anesthesia was applied to PEID group and general anesthesia to FD group. The incision length, operative time, intraoperative blood loss, postoperative bed time, duration of hospitalization and complications between two groups were compared. The Visual Analogue Score (VAS) and the Oswestry disability index (ODI) of two groups were evaluated preoperatively, postoperatively and in last follow-up. The Modified Macnab criteria was used to evaluate the clinical effects at the last follow-up. the changes of serum Creatine Kinase (CK) activity and C-Reactive Protein (CRP) concentration in two groups were compared pre- and postoperatively. Results: According to the modified Macnab criteria, the excellent and good rates in the two groups were 88.57% and 87.09%; the difference was not statistically significant (χ2 = 0.034, P=0.855). There were no statistically significant difference between the two groups in age and gender (P>0.05). The intraoperative blood loss in the PEID group was less than that in the FD group. The incision length, operation time, postoperative bed time, and the duration of hospitalization in the PEID group were shorter than the FD group; the differences were statistically significant (P<0.05). VAS scores (back pain) in the PEID group at various postoperative time point were lower than those in the FD group (P<0.05). VAS (back-leg pain) score and ODI index of the two groups at various postoperative time point were lower than those before operation; the difference was statistically significant (P<0.05). The serum Creatine Kinase (CK) activity and C-Reactive Protein (CRP) concentration in the PEID group were significantly lower than those in the FD group after surgery, and the difference was statistically significant (P<0.05). Comparison of the total incidence of complications was made, and the difference was not statistically significant(χ2=0.053,P=0.818). Conclusion: Both surgical methods can effectively treat L5S1 lumbar disc herniation, but PEID technology has less trauma, less bleeding, shorter bed rest, faster recovery after surgery, and is worth popularizing and applying.
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2021, Vol. 27 
