Spatial Factors Of The Difficult Catheterizing Of Percutaneous Endoscopic Lumbar Discectomy For L5-S1 Intervertebral Disc Herniation

Objective:Measure and analyze the spatial factors which affect the patients with L5-S1 intervertebral disc herniation show difficult catheterizing when were performed percutaneous endoscopic lumbar discectomy(PELD)surgery.And find an easy imaging method to determine whether the patient have the risk of difficult catheterizing.Methods:40 cases who were performed PELD surgery for L5-S1 intervertebral disc herniation in No.1 Hospital of Jilin Univers ity were reviewed.Those cases were divided into high difficult catheterizing group and low difficult catheterizing group by whether the connecting line between the superior border of ilium and the foramen intervertebrale were intersect with processus transversus.Operation time,radiation exposure time,visual analogue scale(VAS)score,oswestry disability index(ODI)score were evaluated.Sorting and analys ising data were proceeded by using SPSS22.0 statistical software.3Dbody software were used to auxiliary analysis the anatomical structure of L5-S1 intervertebral disc herniation.Result:3Dbody software shows the height of iliac crest,the size of transverse process,and the size of foramen intervertebrale and their spatial relationship are the critical factors of the success of PELD.Operation time of high difficult catheterizing group and low difficult catheterizing group was(101±15.6)min and(127±17.6)min respectively.Radiation exposure time of high difficult catheterizing group and low difficult catheterizing group was(9.7±2.6)s and(17.4±3.6)respectively.Those parameters have statistically significant differences(P<0.05).VAS score score of those two groups was(6.0±1.6)and(5.5±1.8),ODI score of those two groups was(19.6±3.6)and(17.8±4.5).There are no statistically significant difference between two groups(P>0.05)Conclusion:The height of iliac crest,the size of transverse process,and the size of foramen intervertebrale and their spatial relationship are the critical factors of the success of PELD.For the patient with L5-S1 intervertebral disc herniation,observing whether the connecting line between the superior border of ilium and the foramen intervertebrale were intersect with processus transversus is an esay maging method to determine whether the patient have the risk of difficult catheterizing.The risk of difficult catheterizing has no significant effect to the expected therapeutic result after success PELD.