Comparison Of The Therapeutic Effect Of Discectomy By Minimally Invasive Channel System Or Percutaneous Transforaminal Endoscopy In Treating Lumbar Intervertebral Disc Herniation

Objective To compare the efficacy of minimally invasive channel system and percutaneous transforaminal endoscopic discectomy in treatment of lumbar disc herniation,and provide reference for the selection of the appropriate surgical method for minimally invasive treatment of lumbar intervertebral disc herniation.Methods In this study,74 patients with lumbar disc herniation in the spinal surgery department of the affiliated hospital of Qingdao university from September,2015 to December,2016,42 males and 32 females.44 patients underwent minimally invasive surgery,24 males and 20 females,aged 20-74(45.0±13.2).30 patients underwent PTED,18 males and 12 females,and the age was 19-77(39.2±14.2).All patients were instructed to return to the hospital in 1month,6 months and 12 months after surgery to review and photograph the lumbar orthotopic X-ray.Operation time,intraoperativeblood loss,length of incision,length of hospital stay,total cost of hospitalization,postoperative complications,VAS,ODI,JOA scores were observed and compared between the two groups.Result There was no significant difference in age,gender,and operative segment(P<0.05)between the two groups,without statistical significance.All of the 74 patients underwent successful operation without severe complications such as epidural rupture and infection.Two groups of patients showed significant differences in VAS,ODI and JOA scores after surgery(P<0.05).But the differences between the groups were not significant(P>0.05).The surgical incision length of the minimally invasive channel system group was more than PTED group;for the operation time,the minimally invasive channel system group was less than PTED group;total cost of hospitalization of the minimally invasive channel group was less than PTED group;for the surgical experience score,the minimally invasive channel group was more than PTED group.The difference between hospital time,intraoperative blood loss and postoperative complications were not statistically significant for the two groups(P>0.05).Conclusion Both minimally invasive channel system and PTED were satisfactory in the treatment of lumbar intervertebral disc herniation.There was no significant difference between the two groups in the postoperative VAS,ODI,JOA scores,hospital stay,intraoperative blood loss and postoperative complications,P > 0.05.Compared with the minimally invasive channel system group,the operation time of the PTED group was longer,the hospitalization cost was higher,and the surgical indications were narrower,but the incision length was shorter and the operation was less traumatic to the tissue.Therefore,both of them have advantages and disadvantages,we needcomprehensively evaluate their respective advantages.In the treatment of lumbar intervertebral disc herniation,they are flexibly selected for different patients.