| Objective:To analyze the effect of the "Jetting suture " annulus fibrosus suture technique in endoscopic discectomy（MED）,and to compare the imaging findings.Methods:A review of cases in Qilu Hospital of Shandong University who were treated with MED for lumbar disc herniation during the period from June 1,2012 to June 1,2019.Among them,30 cases of patients with lumbar intervertebral disc herniation treated by MED combined with "Jetting suture" suture fibrous annulus technology were used as the study group.30 cases of patients who underwent MED operation without suturing the fibrous annulus to treat lumbar intervertebral disc herniation were selected as the control group.The operation time and blood loss of the study group and the control group were collected,and the Macnab curative effect was evaluated by the Japanese Orthopaedic Association（JOA）score,Oswestry disability index score（ODI）,and visual blur score（VAS）assessment.At the same time,the preoperative and postoperative magnetic resonance intervertebral space height and protrusion size were collected in the two groups.Results:The average follow-up time of the two groups was 37.5 months（range 16-57 months）.The age of the study group and the control group（the study group was 18-59（41.40 ± 14.91）years old;the control group was 17-71（37.50±10.43）years old）,gender（14 males in the study group,16 females;15 males in the control group Cases,15 females）,surgical segment（study group lumbar 4/5,11 cases,lumbar 5/sacral 1,19 cases;control group lumbar 4/5,17 cases,lumbar 5/sacral 1,13 cases）,Bleeding volume（22.30±3.14mL in the study group,25.83±27.61ml in the control group）,operation time[113.33±23.35 minutes in the study group,106.03 ± 26.63 minutes in the control group)showed no statistical difference（P>0.05）.There was no statistically significant difference between the study group and the control group in the Macnab,ODI index,VAS score,and JOA score at different time points before and after operation（P>0.05）.The comparison of the ODI index,VAS score and JOA score data between the two groups of patients at the seventh day and the third month after surgery（short-term efficacy）was statistically significant（P<0.05）;The comparison of ODI index,VAS score,and JOA score between thethe study group and the control group at the sixth month after surgery,1 year after surgery,and last follow-up（long-term efficacy）between two adjacent time points was not statistically significant（P>0.05）.The recurrence rate of the two groups（27 cases（90%）without recurrence in the study group,3 cases（10%）with no recurrence;25 cases（83.3%）with no recurrence in the control group,5 cases（16.7%）with recurrence）and reoperation rate（study In the group,30 cases were not re-operation（100%）,0 cases were re-operation（0%）;in the control group,27 cases were not re-operation（90%）,and 3 cases（10%）were not statistically significant（P>0.05）.The preoperative and postoperative intervertebral space heights of the two groups of patients measured by MRI（the study group was 1.03±0.17cm before operation;the postoperative value was 0.95±0.14cm;the control group was 0.94±0.18cm before operation,and the postoperative value was 0.93±0.18cm）The change was not statistically significant（P>0.05）.The postoperative and preoperative protrusion sizes measured by the magnetic resonance of the study group and the control group（control group 0.86±0.16cm before operation,0.57±0.18cm after operation;study group 0.94±0.14cm before operation;after operation）0.37 ± 0.08cm）The change contrast was statistically significant（P<0.05）.Conclusion:"Jetting suture" annulus fibrosus suture in MED is safe and effective,does not affect the postoperative height of the intervertebral space,and the residual protrusions in the operation area are smaller,which has a certain promotion value. |
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