Observation On Short-term Effect Of The Microendoscopic Discectomy And Nerve Root Canal Decompression In The Treatment Of The Lumbar Disc Herniation With Lateral Recess Stenosis

Objective:Retrospective evaluation of the clinical short-term curative effect of the microendoscopic discectomy and nerve root canal decompression in the treatment of the lumbar disc herniation with lateral recess stenosis.Methods:Retrospectively analyzed 59 patients (from March 2014-August 2015 in orthopedic department of Sichuan Province People’s Hospital)with lumbar disc herniation with lateral recess stenosis.The all 59 patients were divided into group M-NCD and group O-NCD according to different operation way. The group M-NCD was consisted of 28 patients who all underwent the microendoscopic discectomy and nerve root canal decompression, and the group O-NCD was consisted of 31 patients who all underwent the open discectomy and nerve root canal decompression. Both the groups were subject to the same postoperative therapy. There was no statistically significant difference between the two groups of patients’ age, gender, preoperative VAS(Visual Analogue Scale, VAS),JOA(Japanese orthopedic association Low Back pain score, JOA), preoperative LBOS(Low Back Outcome Scale, LBOS) and preoperative ODI (Oswestry disability index, ODI)(p>0.05).The observation targets were as follows:operation time, intraoperative blood loss, incision length, hospitalization days,two groups of patients with preoperative and postoperative 3 days VAS, and the JOA, ODI, LBOS of postoperative 1 month,3 months,6 months follow-up.Result: ①The group M-NCD compared with the group O-NCD, there was no statistically significant difference in patients’ age, gender, preoperative VAS, JOA, preoperative LBOS and preoperative ODI (p>0.05).There was no statistically significant difference in operative time, intraoperative blood loss, hospitalization days between two groups (p>0.05).There was statistically significant different in incision length(p<0.01).②Preoperative compared with the postoperative, the VAS of two groups was statistically significant different (p<0.01). Preoperative compared with the postoperative 1 month,3 months,6 months, the JOA, LBOS and ODI of two groups were statistically significant different (p<0.01).③The comparison among the postoperative 1 month,3 months,6 months, the JOA improvement point was statistically significant different (p<0.01). ④ There was no statistical significant difference in postoperative 3 days VAS and JOA, JOA improvement point, LBOS, ODI of postoperative 1 month,3 months,6 months between two groups (p> 0.05).Conclusion:Both the microendoscopic discectomy and nerve root canal decompression and the open discectomy and nerve root canal decompression in the treatment of the lumbar disc herniation with lateral recess stenosis could achieve good clinical short-term effect, and the short-term efficacy of two kinds of operation was similar. With the short learning curve,similar operation steps, and same good clinical short-term effect, the MED could be charged easily by the surgeon with the experience in laminar fenestration. So, the MED promotion could be in the hospital with the equipment, and laminar fenestration could be choosed for the treatment of the lumbar disc herniation with lateral recess stenosis in the hospital without the equipment.