Comparison of the clinical efficacy of percutaneous transforaminal endoscopic discectomy and minimally invasive transforaminal lumbar interbody fusion in patients with lumbar disc herniation
Objective:To compare the clinical efficacy of foraminal endoscopic nucleus pulposus extraction(PTED)and minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)in the treatment of patients with lumbar disc herniation(LDH).Methods:A total of 92 LDH patients admitted to Ruzhou Orthopedic Hospital from June 2020 to February 2023 were collected and randomly divided into the PTED group and MIS-TLIF group,with 46 cases in each group.PTED group underwent PTED and MIS-TLIF group underwent MIS-TLIF.After 3 months of surgery,the operative efficacy,and perioperative indexes were compared between the two groups.After 1 day and 3 days of surgery,the enzyme-linked immunosorbent assay was used to detect tumor necrosis factor-α(TNF-α),procalcitonin(PCT),and C-reactive protein(CRP)levels.After 1 month and after 3 months of surgery,a numerical rating scale(NRS)was used to evaluate the pain degree,Oswestry disability index(ODI)was used to evaluate the lumbar function.After 3 months of postoperative follow-up,the complications were compared between the two groups.Results:After 3 months of surgery,the excellent and good rate of operation in the PTED group was higher than that in the MIS-TLIF group(P<0.05).The intraoperative blood loss in the PTED group was less than that in the MIS-TLIF group,and the incision length,operation time,first postoperative activity time,and hospitalization days were shorter than those in the MIS-TLIF group(P<0.05).After 1 day and 3 days of surgery,the serum levels of TNF-α,PCT,and CRP in the PTED group were lower than those in the MIS-TLIF group(P<0.05).After 1 month and 3 months of surgery,ODI and NRS scores in the PTED group were lower than those in the MIS-TLIF group(P<0.05).The complication rate of the PTED group was lower than that of the MIS-TLIF group(P<0.05).Conclusion:PTED has a better effect on LDH patients,which can optimize perioperative indexes,reduce the inflammatory response and postoperative pain,reduce the occurrence of complications,and improve lumbar function.
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