The Clinical Observation On Acupuncture Promoting Rehabilitation After Transforaminal Endoscopic Discectomy For LDH

Objective:Based on the theory of "bone dislocation and tendon out of groove ",this research observed the effect of acupuncture and active back muscle exercise on postoperative curative effect of patients with LDH after transforaminal endoscopic treatment,and discussed the necessity of treating LDH from the perspective of etiology,so as to provide theoretical and practical basis for improving the curative effect of transforaminal endoscopic treatment and the formulation of enhanced recovery program.Methods:Sixty patients with lumbar disc herniation who were hospitalized in the Department of orthopedics,Jiangsu Provincial Hospital from May 2020 to December 2020 were enrolled.According to the random number distribution table,they were divided into observation group and control group,30 cases in each group.Both groups were treated with transforaminal endoscopic surgery.The control group was given regular back muscle exercise in bed on the second day after surgery.The observation group was given back muscle exercise combined with acupuncture treatment.VAS score,M-JOA score,ODI index score and length of hospital stay were observed and recorded before and 3 days,1 month and 3 months after operation and the location of lumbar spinous process,vertebral rotation and bilateral facet joint space were measured before and 1 months after operation and 3 months after operation in two groups.Finally,the collected data are summarized and statistically analyzed.Results:(1)A total of 60 patients were included in this study,including 59 patients with complete clinical data and 1 patient with abscission in the control group.The basic data of the two groups including gender,age,BMI,course of disease,involved segments,etc,and there was no significant difference in preoperative general information(P>0.05).(2)VAS score,M-JOA score,ODI score,spinous process offset distance,vertebral rotation angle and bilateral facet joint space before surgery were compared between the groups,and the difference was no statistically significant(P>0.05).(3)The VAS score,M-JOA score and ODI score of the two groups at 3 days,1 month and 3 months after operation were lower than those before operation(P<0.001);The difference of spinous process offset,vertebral rotation angle and bilateral facet joint space width between the two groups at 1 month and 3 months after operation were significantly decreased(P<0.001).(4)In the changes of the above indexes,the change amplitude of the observation group was greater than that of the control group(P<0.05).(5)The postoperative hospitalization time of the observation group was shorter than that of the control group(P<0.001).Conclusions:1.Acupuncture after percutaneous transforaminal endoscopic surgery can better relieve the pain of patients with lumbar disc herniation,improve the symptoms of patients,and accelerate the recovery of patients,which is worthy of clinical promotion;2.It is an important pathological change of lumbar disc herniation that "bone dislocation and tendon out of groove".Through acupuncture and back muscle exercise to correct the pathological state of "tendon bone imbalance",that can obtain better clinical curative effect.