Analysis Of The Disc Working Zone For Percutaneous Endoscopic Lumbar Discectomy

Objective:To measure the distance between the articular processes of the lumbar 4(L4)nerve and the superior articular process of lumbar 5(L5)in normal adults and Lumbar disc herniation(LDH)by magnetic resonance imaging(MRI).This study discusses the security of Percutaneous Endoscopic Lumbar Discectomy(PELD)treating Lumbar Disc Herniation(LDH),and provides accurate the imaging reference date for the clinical application of PELD.Methods: The 68 patients was collected from June 2016 to December2016 in our hospital MRI room.Patients were divided into prominent group and normal group according to whether or not L4 / 5 disc is protrusion.All the68 patients is aged 20-40 years,and the patients without abnormal scoliosis and kyphosis,cross-sectional images parallel to the upper and lower end plate level.All the date was measureed by the PACS(Picture Archiving and Communication Systems)system software.The marker pen was used to marke the facet of the joint of the L5 on the computer screen.Carefully observing the morphology of the intervertebral foramen and the nerve root,we measure the end plate and the intervertebral space,the distance between the nerve root and the marker point of the endplate level,and the data was recorded.All the data were measured by two people,and all the data were analyzed in this study.Results:The mean value of the height of the normal group was 8.66±0.65 mm and the prominent group was 5.91 ± 0.40 mm,the difference wasstatistically significant(p <0.05).The distance of normal group between the point and the nerve of bottom level was 4.29 ± 1.36 mm on the left and 4.45 ±1.57 mm on the right.The intervertebral level was 7.03 ± 1.41 mm on the left and 7.15 ± 1.41 mm on the right.The up level was 11.48 ± 1.16 mm on the left,the right side of 11.42 ± 1.27 mm.As for the protrusion group,the distance of between the point and the bottom level was 4.58 ± 1.98 mm on the symptomatic side and another side was 4.72 ± 1.80 mm.The intervertebral level was 7.35 ± 1.72 mm on the symptomatic side and another side was 7.18 ±1.77 mm.The up level was 12.07 ± 2.06 mm on the symptomatic side,and another side was 11.72 ± 2.10 mm,the difference was not statistically significant(p <0.05).Conclusion:1.Lumbar intervertebral disc herniation can lead to the decrease of intervertebral space height,but it can not change position of the nerve root.2.As for the L4 / 5 intervertebral disc 1 and 2 area prominent patients of 20-40 year old,the distance between the articular facet and the nerve root is greater than the working channel radius,we can try to slide along the tip of the articular process into spinal canal,or intervertebral foramen formation will not damage the root of the export.