COMPARISON OF CLINICAL EFFICACY AND SAFETY OF DIFFERENT APPROACHES IN THE TREATMENT OF LDH

Xuegang Lun^{1, #}, Xiaomin Li^{2, #}, Feng Wang³, Jianmin Sun^{4, *}

¹Department of Spinal and Spinal Cord, Shandong Wendeng Osteopath Yantai Hospital, Yantai 264499, PR China - ²Medical Record Room, Shandong Wendeng Osteopath Yantai Hospital, Yantai 264499, PR China - ³Department of Tranma,Shandong Wendeng Osteopath Yantai hospital, Yantai 264499, PR China - ⁴Department of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, PR China 

^#These authors contributed equally to this work a

Objective: To investigate the clinical efficacy and safety of different approaches in the treatment of lumbar disc herniation (LDH).

Methods: Seventy patients with LDH treated by spinal endoscopy were divided into foramen approach group (group A) and interlaminar approach group (group B) according to different surgical methods. The operation, complications, lumbar function and clinical symptoms of the two groups were observed and compared. 

Results: The intraoperative blood loss,operation time, and intraoperative fluoroscopy in group B were reduced than those in group A (P<0.05), but the postoperative bed rest time, hospital stay, and curative effect of modified MacNab standard operation between the two groups were no difference (P>0.05). After operation, the scores of VAS and ODI in the two groups were reduced than those before operation, while the scores of JOA score system were raised than those before operation, but there was no significant difference in VAS, ODI and JOA scores between the two groups before and after operation. The incidence of complications in group B was reduced than that in group A (P<0.05).

Conclusion: PETDand PEID are effective in the treatment of LDH, but percutaneous spinal endoscopic interlaminar windowing discectomy has shorter operation time and less bleeding, and percutaneous spinal endoscopic interlaminar windowing discectomy has a lower risk of dural sac injury.