Comparison of clinical efficacy of transpedicle dynamic fixation and transforaminal interbody fusion in the treatment of single-segment lumbar disc herniation
Comparison of clinical efficacy of transpedicle dynamic fixation and transforaminal interbody fusion in the treatment of single-segment lumbar disc herniation
Objective To study the efficacy of transpedicle dynamic fixation and transforaminal interbody fusion in the treatment of single-segment lumbar disc herniation.Methods A total of 100 patients with single-segment lumbar disc herniation admitted to People's Hospital of Tongchuan from January 2023 to March 2024 were retrospectively selected and divided into the study group(n=50)and the control group(n=50)according to different surgical methods.The study group was treated by transpedicle dynamic fixation and the control group was treated by transforaminal interbody fusion.The operation related indexes(operation bleeding volume,operation time,postoperative ambulation time),the height of intervertebral space of the surgical segment,the range of motion of the lumbar spine(the range of motion of the first adjacent segment of the head side,the range of motion of the lumbar surgical segment,the overall range of motion of the lumbar spine),the Oswestry disability index(ODI),the lumbar and leg pain[visual analogue scale(VAS)score]before operation and 1 year after operation,clinical efficacy and complica-tions were compared between the two groups.Results The amount of bleeding in the study group was(152.03±51.15)mL,which was lower than that in the control group[(198.36±75.14)mL],the operation time and postoperative ambulation time were(160.14±36.42)min and(3.28±0.51)d,respectively,which were shorter than those in the control group[(178.36±38.13)min and(3.92±0.54)d],and the differences were statistically significant(P＜0.05).At 1 year after operation,the intervertebral space height of the surgical segment in the study group was lower than that before operation,and the range of motion of the lumbar surgical segment in the control group was higher than that before operation,the intervertebral space height of the surgical segment in the study group was(10.01±1.97)mm,which was significantly lower than that in the control group[(11.91±1.68)mm],and the differences were statistically significant(P＜0.05).At 1 year after operation,the range of motion of the first cephalic adjacent segment and the overall range of motion of the lumbar spine in the two groups were significantly higher than those before operation,and the range of motion of the surgical segment was significantly lower than that before operation,the differences were statistically significant(P＜0.05).At 1 year after operation,the range of motion of the first adjacent segment of the head in the study group was(8.91±2.84)°,which was lower than that in the control group[(10.22±3.06)°],and the range of motion of the surgical segment was(4.38±0.91)°,which was higher than that in the control group[(1.42±0.61)°],the differences were statistically significant(P＜0.05).There was no statistically significant difference in the overall activity of the lumbar spine between the two groups at 1 year after operation(P＞0.05).At 1 year after operation,the ODI of the two groups were significantly lower than those before operation,and the differences were statistically sig-nificant(P＜0.05);there was no statistically significant difference in ODI between the two groups at 1 year after operation(P＞0.05).At 1 year after operation,the VAS scores of low back pain and leg pain in the two groups were significantly lower than those before operation,and the differences were statistically significant(P＜0.05);there were no statistically significant differences in VAS scores of low back pain and leg pain between the two groups at 1 year after operation(P＞0.05).The excellent and good rate of the study group was 82.00％,which was higher than that of the control group(66.00％),and the difference was statistically significant(P＜0.05).The total complication rate of the study group was 6.00％,which was lower than that of the control group(26.00％),and the difference was statistically significant(P＜0.05).Conclusion Transpedicular dynamic fixation and transforaminal interbody fusion are effective in the treatment of single-segment lumbar disc herniation.However,compared with transforaminal interbody fusion transpedicular dynamic fixation has lower intraoperative blood loss,shorter operation time and postoperative ambulation time,better segmental mobility,and can further reduce the risk of adjacent segment degeneration.
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