Comparative Analysis Of Two Operative Methods Of Lumbar Disc Herniation

Objective: To Observe the efficacy of simple discectomy and interbody fusion in thetreatment of patients with lumbar disc herniation.Methods: We did a retrospective study of lumbar disc herniation patients with simplediscectomy and interbody fusion in our hospital from January2007to December2010,aged from50to65years old, except the upper lumbar disc herniation, combinedmulti-segmental lumbar disc herniation, lumbar spinal stenosis, lumbar not steady, withlumbar spondylolisthesis, extreme lateral lumbar disc herniation.We finally obtain40casesof follow-up patients and their clinical data by telephone follow-up, e-mail follow-up andoutpatient follow-up, including simple nucleus pulposus removed surgery group (singlepick group)19cases, lumbar interbody fusion group21cases, recording operation time,bleeding, hospitalization days and cost of treatment; evaluating clinical curative effect oftwo groups with the Oswestry Disability Index, ODI:0~100%, LBOS, JOA low back painscore and Roland-Morris Disability Questionnaire(RDQ). Measured preoperatively and atfollow-up disc space height ratio and lesion bow top distance.Results: We followed up for24~70months, average46.6months. Simple discectomygroup has obvious advantage (p<0.05) in the operation time, bleeding volume, the cost oftreatment. Arch roof of two groups were improved after three months and final follow-upafter operation, and there was statistical significance (p <0.05). Bow crest interbody fusionfrom each time point had no statistical significance between the two groups (p>0.05).Height between discs compared with those before operation showed no significantdifference (p>0.05) in interbody fusion group after3months and final follow-up; Heightbetween discs compared with those before operation showed no significant difference (p>0.05) in simple discectomy group after3months,but had significant difference (p <0.05)in final follow-up; comparison of height between discs between the two groups after threemonths and final follow-up, interbody fusion group was better than simple discectomygroup, and the difference had statistical significance (p<0.05). ODI score, LBOS score, JOA score, RDQ score of two groups before operation, three months after operation and atfinal follow-up were significantly improved compared with preoperative. There is nosignificant difference in efficacy between the two groups (p>0.05)Conclusion:1, Simple discectomy and interbody fusion both are effective operations for the treatmentof adult lumbar disc herniation.2,Interbody fusion group had longer operation time, bleeding more and costing more, butwas beneficial to obtain immediate stability of lumbar spine and positively maintainlumbar intervertebral height.3, Simple discectomy with less trauma and less cost can obtain the basicly equivalentoperation effect of interbody fusion, while avoiding the risks associated with built-inobjects, more suitable for those single stage single lumbar disc herniation patiencesbetween50to65years old.