Efficacy of percutaneous transforaminal endoscopic discectomy on single-segment lumbar disc herniation with endplate defects
Objective To investigate the efficacy of percutaneous transforaminal endoscopic discectomy(PTED)on single-segment lumbar disc herniation(LDH)with endplate defects.Methods Seventy patients with single-segment LDH combined with endplate defects admitted to the First Affiliated Hospital of Harbin Medical University between January 2020 and January 2022 were retrospectively analyzed.Patients were divided into control group(group A,n=35)and observation group(group B,n=35)according to the surgical methods.Fenestration discectomy(FD)and PTED were performed in group A and B,respectively.Surgery-related indicators(operation time,length of stay,intraoperative bleeding and length of surgical incision)and recovery-related indicators were compared.Pain,postoperative recovery and lumbar disc function were assessed before and 1 week after treatment in both groups.Results Patients in group B had significantly shorter operation time and length of stay,less intraoperative bleeding,and shorter length of surgical incision than those of group A.The total effective rate in group B was significantly higher than that of group A(82.9％vs 60.0％,P＜0.05).There were no significant differences in the scores of preoperative Visual Analogue Scale(VAS),Japanese Orthopaedic Association(JOA)and Oswestry Disability Index(ODI)between the two groups(P＞0.05).The VAS,JOA and ODI scores in the two groups were improved significantly after treatment.Patients in group B had significantly lower VAS and ODI scores,but higher JOA scores after treatment than those of group A(P＜0.05).The incidence of postoperative complications was significantly higher in group A than that of group B(25.7％[9/35]vs 5.7％[2/35],X2=5.285,P=0.022).Conclusion PTED has a good therapeutic effect on single-segment LDH with endplate defects,which accelerates surgical recovery,reduces hospitalization time,intraoperative bleeding,postoperative pain and postoperative complications,and restores lumbar spine function.
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