Comparative Analysis Of Discectomy In The Tube Of MAST^TM QUADRANT^TM And Fenestration Discectomy In The Treatment Of Single Lumbar Disc Herniation

Objective:To estimate the short-term effect of discectomy in MASTTM QUADRANTTM expanding minimally invasive tube and fenestration discectomy in the treatment of single lumbar disc herniation and compare the advantages and disadvantages between the two different ways of operations.Methods:seventy-five cases operated in spine suegery department of the People’s Hospital of Wuhan University were analyzed. Fourty-one of them were operated in MASTTM QUADRANTTM expanding minimally invasive tube system and the rest thirty-four had a fenestration discectomy. The operating time, blood loss, length of cut, duration and expenses of hospitalization, as well as the JOA and ODI Scores were recorded before the operations by the same doctor. After the operations, all the patients were followed up in clinics. Six months later, thirty-seven cases were followed up in the minimally invasive group, while thirty-two cases were followed up in FD group. They were given another JOA and ODI Scores by the prior doctor when they were followed up in clinics. Two independent samples t-test was used in comparing and analyzing the two groups of patients before and after operations. Results: 1、Two independent samples t-test was used in comparing the length of cut, FD group5.78±0.55cm, invasive group2.20±0.17cm, p<0.001. There was a significant difference between the two groups.2、Two independent samples t-test was used in comparing the blood loss of the two groups, FD group141.18±24.34ml, invasive group72.71±17.26ml, p<0.001. There was a significant difference between the two groups.3、Two independent samples t-test was used in comparing the operating time of the two groups, FD group74.56±9.95min, invasive group50.02±9.58min, p<0.001. There was a significant difference between the two groups.4、Two independent samples t-test was used in comparing the durationof hospitalization of the two groups, FD group7.91±0.90days, invasive group7.44±1.40days, p>0.05. There was no significant difference between the two groups.5、Two independent samples t-test was used in comparing the expense of the two groups, FD group11135.82±1971.45MB, invasive group12043.02±2508.16RMB, p>0.05. There was no significant difference between the two groups.6、JOA and ODI scores of two groups were given by the same doctoc before and after operation. Two independent samples t-test was used in comparing JOA and ODI scores before operation.It shows p>0.05. There was no significant difference between the two groups when they were of preoperative. When the patients of these two groups were followed up, another JOA and ODI scores were given to everyone. Two independent samples t-test were used in comparing the JOA and ODI scores of these two groups.It shows p>0.05. There was no significant difference between the two groups.It can be proposed that there was no significant difference between the two groups in relieving nerve root compression, waist and leg pain, and easing Neurological symptomsAs a general analysis, it showed that no significant difference was found in duration, expenses of hospitalization,as well as the JOA and ODI Scores after opration between two groups. But the minimally invasive group was more excellent than the other one in oprating time, blood loss and length of cut.Conclusion:Both ways of discectomy could obviously relieve nerve root compression, waist and leg pain, and Neurological symptoms. But the discectomy in the tube of MASTTM QUADRANTTM expanding minimally invasive had advantages of less trauma, less blood loss, less pain after opration and earlier rehabilation.