| Objective:To analyze the short-term clinical efficacy of percutaneous transforaminal lumbar intervertebral disc herniation and to observe the effect of age on the curative effect.Methods:Retrospective analysis of the Department of Orthopaedics(Spine Surgery)in our hospital from March 2018 to September 2018 for lumbar disc herniation for percutaneous transforaminal nucleus pulposus removal inpatients,collecting all patients age,gender Clinical data such as duration of disease,surgical segment,operation time,length of hospital stay,and surgical expenses.According to the inclusion and exclusion criteria,the collected cases were divided into three groups: A youth group(age ? 45 years old),B middle age group(45 years old < age < 60 years old),and C old age group(age ? 60 years old).The three groups were analyzed for VAS score and ODI score 1 day before surgery,3 months after surgery,and 6 months after operation.The pain and dysfunction were evaluated.The excellent rate of improvement was evaluated by modified Macnab at the end of follow-up.Finally,statistical software was used to analyze the VAS score and ODI index of all patients before and 1 day after surgery,3 months after surgery and 6months after operation.The overall efficacy of the operation was evaluated.Results:(1)A total of 108 patients were enrolled,including 72 males and 36 females,aged between 19 and 82 years,with a mean age of(47.0 ± 14.78)years.All patients had an average preoperative VAS score of 7.12±0.78 and an ODI of 70.75±3.70.The mean VAS score was 1.81±0.97 on the 1st postoperative day,and the ODI index was 21.24±8.16.The mean VAS score was 2.01±0.98 and the ODI index was 20.86±8.82.The average score of VAS in June was 2.11±1.11,and the ODI index was 21.65±9.53.Among them,A group(age ? 45 years old)had 51 patients(39 males and 12 females)with an age distribution ranging from 19 to 45 years old,with an average of(34.12±6.93)years and an average course of disease(9.55±6.63)months.Highlighted segments L3/4(2 cases),L4/5(32 cases),L5/S1(17 cases);B middle-aged group(45 years old <age <60 years old)had 34 patients(21males,females)13 cases),age distribution between 45-60 years old,average(52.18±3.76)years old,average disease duration(9.29±5.82)months,prominent segment L3/4(4 cases),L4/5(19 cases),L5 /S1(11 cases);C elderly group(age?60 years old)had 23 patients(12 males and 11 females)with an age distribution of 60-82 years old,with an average of(68.04±6.59)years old,with an average course of disease(10.48±10.34)months,prominent segments L3/4(2 cases),L4/5(14 cases),L5/S1(7 cases).(2)Comparison between different age groups: There was no significant difference in VAS score and ODI index at 1 day after operation(P>0.05).There was significant difference in VAS score and ODI index at 3 months after operation(P<0.05).There was a statistically significant difference in VAS score and ODI index between the 6th month after operation(P<0.05).The VAS score and ODI index of the C group were higher than those of the other two age groups.The difference was statistically significant(P<0.05),there was no significant difference in postoperative VAS score and ODI index between the other two age groups(P>0.05).There was no significant difference in the excellent rate between the three groups in the end-stage follow-up modified Macnab(P>0.05).(3)The average length of hospital stay in the three different age groups was A(3.42±2.31)days,B middle-aged group(4.74±2.67)days,and C-old group(6.13±2.91)days.Statistical difference(P<0.05),the hospitalization time of A group was significantly lower than that of C group(P=0.000).The average operation time of the three groups was(91.67±29.05)minutes.There was no statistical difference between the three groups.The difference was(P>0.05).The average operation cost of the three groups was(8144.79±1506.03)yuan.There was no significant difference between the three groups(P>0.05).(4)All patients were compared by gender.There was no significant difference in preoperative and postoperative VAS scores and ODI index between male and female groups(P>0.05).All patients were preoperatively and 1 day after surgery.The difference of VAS score and ODI index between March and June was statistically significant(P<0.05).The overall excellent and good rate of improved Macnab in end-stage follow-up was 91.7%.conclusion:Percutaneous transforaminal technique is effective in the treatment of lumbar disc herniation in different age groups.Young patients recover quickly and hospitalization time is short.When strictly selected indications,clinical application should be biased towards young and middle-aged patients. |
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