Clinical Observation Of Percutaneous Transforaminal Endoscopic Discectomy For Lumbar Disc Herniation

Objective:To observe the clinical efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of patients with single lumbar disc herniation.Methods:Lateral-posterior approach percutaneous transforaminal endoscopic nucleus pulposus discectomy was carried out in35cases of single lumbar disc herniation,the clinical efficacy was evaluated by the application of Oswestry disability index (ODI), pain visual analog scale (VAS score),improved Macnab criteria and imaging examination.Results:The operations of35patients were successfully completed, The operation time was60-90min, the average (75±7) min,and the blood loss was20±35ml,the average (25±3) ml. The postoperative back pain was significantly reduced or disappeared immediately. Intraoperative dural injury and guide pin fracture occurred in1case each. Postoperative nerve root injury,lower extremity sensory disturbances and edema reaction was found in1case each too:Compared with preoperative VAS score,the postoperative VAS was significant lower after1month,3month and6months. According to ODI, the postoperative daily life quality was obviously improved within1month, daily activity and function almost returned to normal in6months after the operation. In accordance with the improved Macnab evaluation criteria,the excellence rate was82.9%. Imaging results showed that most of the intervertebral disk herniation disappeared. Only1case complained mild sensory disturbances of lower extremity after surgery,and the symptoms apparently relieved3months after treated by nerve nutrition drugs. Conclusions:PTED is an effective treatment method for lumbar disc herniation,with the characteristics of minimal wound,little hemorrhage,and its clinical efficacy is reliable.