Evaluate The Different Minimally Invasive Surgery’s Treatment Of Lumbar Disc Herniation By MRI Image

Objective:Evaluate the efficacy of radiofrequency thermocoagulation target surgery and intervertebral foramen endoscopic nucleus pulpotomy in the treatment of lumbar disc herniation by MRI images.Compare the efficacy of the two methods.Investigate the correlation between JOA score and longitudinal axis of epidural indentation.Investigate whether the degree of intervertebral disc degeneration affects the postoperative efficacy.Methods:Collected patients who have received the radiofrequency treatment of heat setting targets and intervertebral foramen lens nucleus pulposus excision to treat the lumbar intervertebral disc protrusion(prominent type is central type)50 cases each,a total of 100 cases,from January 2016 to January 2019,both received the preoperative and postoperative MRI examination,JOA score in clinical symptoms.Review the patient s MRI findings and JOA score results.According to the surgical divide patients into A,B group(group A are the patients who receive heat coagulation treatment of targets,group B are the patients who treated with excision of nucleus pulposus intervertebral foramen mirror),according to the patients with herniation of preoperative JOA score divide the patients into three groups,mild,moderate and severe group.The radiographic evaluation of surgical efficacy was performed according to the reduced value of intervertebral disc obtained from MRI images.The improvement rate RIS calculated based on JOA score was used for clinical evaluation of surgical efficacy.Finally,the surgical efficacy of group A and group B was compared as a whole and was compared in three groups:light group,medium group and heavy group.Discuss the correlation between JOA score and the longitudinal axis of epidural indentation.According to the degree of disc degeneration,1-4 degrees were divided into groups for comparison between groups to observe the difference in postoperative efficacy.Results:1.The longitudinal value of preoperative epidural indentation in group A was 9.00(2.25)mm,the postoperative longitudinal value of postoperative epidural indentation was 2.50(3.00)mm,the postoperative disc reduction value was 6.00(2.00)mm,the preoperative JOA score was 12.00(5.00),the postoperative JOA score was26.00(2.00),and the improvementate RIS was 0.77±0.08.The patients treated with rf thermocoagulation target had significant postoperative efficacy.2.The longitudinal value of preoperative epidural indentation in group B was 9.00(2.25)mm,the postoperative longitudinal value of postoperative epidural indentation was 2.00(1.00)mm,the postoperative disc reduction value was 7.00(2.00)mm,the preoperative JOA score was 13.00(6.00),the postoperative JOA score was 26.00(2.00),and the improvement rate RIS was 0.83±0.07.3.The intergroup comparison of group A and group B as A whole showed that the reduction value of intervertebral disc in group A was 6.00(2.00)mm,the improvement rate of RIS was 0.7710.08;In group B,the reduction value of intervertebral disc was 7.00(2.00)mm,and the improvement rate of RIS was 0.83±0.07,P<0.05,The overall efficacy of group B was higher than that of group A.4.Group A and group B were divided into light,medium and heavy groups for comparison.Comparison of mild group A and B,P>0.05.The difference was not statistically significant.Moderate and severe group A and B were compared,P<0.05.The difference was statistically significant.5.Preoperative JOA score was compared with the longitudinal axis of epidural indentation.It was found that JOA score was negatively correlated with the longitudinal axis of epidural indentation.That is,the larger the vertical axis of the epidural indentation,the lower the JOA score,and vice versa.6.The intervertebral foramen stenosis and lateral recess stenosis before and after operation were compared between group A and group B.All P values were greater than 0.05.Therefore,the improvement rates of intervertebral foramen stenosis and lateral recess stenosis in the two groups before and after surgery were not considered to be different.7.According to the degree of intervertebral disc degeneration,patients in group A and group B were divided into four groups of 1,2,3 and 4 degrees.The relationship between degenerative degree and postoperative improvement rate was observed.In group A,the degree of disc degeneration was lower and the improvement rate was higher,while in group B,there was no correlationConclusions:1.For moderate and severe patients,the postoperative efficacy of endoscopic nucleus pulposus extraction is higher than that of radiofrequency thermocoagulation.2.JOA score was negatively correlated with the longitudinal axis of epidural indentation.3.There was no difference in efficacy between radiofrequency thermocoagulation target and endoscopic nucleus pulposus extraction in the treatment of intervertebral foramen/lateral recess stenosis.4.The less degree of preoperative intervertebral disc degeneration,the be-tter the postoperative curative effect.