| Objective:In order to evaluate the clinical efficacy of percutaneous endoscopic lumbar discectomy(PELD)in patients with or without Modic changes(MCs)for lumbar disc herniation(LDH),the preoperative symptoms,postoperative efficacy and other indicators of these patients were compared,and the differences in clinical efficacy of these patients after PELD were finally discussed.Methods:An examination of clinical data from patients with lumbar disc herniation admitted to our hospital’s spinal traumatology department between June 2021 and June 2022,who underwent PELD surgery,was conducted as part of this study.A total of 108 patients fulfilled the criteria for inclusion were divided into non Modic changes group(group A),MCs1 group(group B)and MCs 2 group(group C),which were grouped based on the presence and absence of Modic changes.There were 64 cases in group A(42 males and 22 females),21 cases in group B(16 males and 5females),and 23 cases in group C(12 males and 11 females).A comparison and analysis of the VAS score of waist and leg,as well as ODI score,of three groups of patients before and after surgery was conducted.Additionally,the modified Macnab method was used to evaluate excellent and good treatment 3 months and 6 months after surgery.Statistical analysis of the results was performed using SPSS25.0statistical software.Results:This study included 108 complete patients,all of whom were collected and included.The main results of this study were:(1)No noteworthy disparities in gender,age,BMI,lesion segment,course of illness,and duration of stay were observed between the three groups(P>0.05).(2)The VAS scores of waist at 3 days after surgery,3 months and 6 months after surgery were lower than those before surgery(P<0.05).Inter-group comparison showed that the VAS scores of waist of the three groups was statistically significant at 3 months and 6 months after surgery(P<0.05).A comparison of multiple groups revealed that the disparities between group A and group B,and between group A and group C,were statistically significant(P<0.05),whereas the disparities between group B and group C were not(P>0.05).(3)At each post-surgery time,the VAS scores of the legs of the three groups were lower than those prior to the operation(P<0.05).No noteworthy divergence in VAS scores of legs was observed between the three groups prior to and post-surgery(P>0.05).(4)The ODI score of the three groups at each time after surgery was significantly improved compared with that before surgery(P<0.05).The inter-group comparison found that there was a statistically significant difference in the ODI scores between the three groups at 3 and6 months after the operation(P<0.05).The differences between group A and group B,group A and group C were statistically significant(P<0.05),while the differences between group B and group C were not statistically significant(P>0.05).(5)The modified Macnab method yielded satisfactory excellent and good rates for the three groups of patients,yet no statistical significance was observed after 3 and 6 months of operation(P>0.05).Conclusion:(1)The efficacy of PELD in treating lumbar disc herniation is clear,and it is a successful option for those with Modic changes.(2)PELD was more effective in relieving back pain and leg pain in LDH patients with non Modic changes.The relief of back pain and recovery of lumbar function after PELD are negatively affected by MCs 1 and MCs 2. |
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