Effect of transforaminal technique via different approaches in the treatment of upper lumbar disc herniation and analysis of the influencing factors of recurrence during follow-up
Objective To investigate the effect of transforaminal technique via different approaches in the treatment of upper lumbar disc herniation(ULDH)and analysis of the influencing factors of recurrence during follow-up.Methods The clinical data of 120 patients with ULDH who underwent transforaminal technique admitted from January 2019 to January 2022 were retrospectively analyzed.According to the different surgical approaches,the patients were divided into percutaneous endoscopic transforaminal discectomy(PETD)group(treated with PETD)and percutaneous endoscopic interlaminar discectomy(PEID)group(treated with PEID),with 60 cases in each group.The Oswestry Disability Index(ODI),Visual Analogue Scale(VAS)scores and recurrence rate during follow-up were compared between the two groups;multivariate Logistic regression analysis was used to explore the risk factors of recurrence during follow-up.Results At 3 d,3 months and 6 months after operation,the ODI and VAS scores of the two groups were lower than those before operation(P<0.05);at 3 d after operation,the ODI score of the PEID group was lower than that of the PETD group(P<0.05);at 3 months after operation,the VAS score of the PEID group was higher than that of the PETD group(P<0.05).The recurrence rate during follow-up of the PETD group was higher than that of the PEID group(P<0.05).The proportions of body mass index(BMI)≥24 kg/m2,alcohol drinking history,diabetes and prominent type in the recurrent group were higher than those in the non-recurrent group(P<0.05).BMI≥24 kg/m2,alcohol drinking history,diabetes,prominent type and PETD were risk factors for recurrence during follow-up(P<0.05).Conclusion Both PETD and PEID are effective in the treatment of ULDH,and PEID is more effective.High BMI,alcohol drinking,diabetes,prominent type,and PETD were risk factors for recurrence during follow-up.
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