A study on the effect of modified percutaneous transforaminal spine endoscopy in the treatment of the elder with lumbar disc herniation

English Keywords:Percutaneous transforaminal spine endoscopy  Lumbar disc herniation  Clinical effect

English Abstract:

  【Abstract】 Objectives: To explore the clinical effect of modified percutaneous transforaminal spine endoscopy in the treatment of elderly patients with lumbar disc herniation. Methods: 130 patients with advanced lumbar disc herniation were selected from March 2016 to March 2019, and were randomly divided into control group and observation group, with 65 cases in each group. The control group included 37 males and 28 females, averaged 66.4±5.3(61-75) years old, and they were treated with fenestration discectomy. The observation group had 35 males and 30 females, averaged 66.9±5.3(62-77) years old, and they were treated with modified percutaneous transforaminal spine endoscopy. The biomechanical properties of the low back muscles measured at 60°/s and 120°/s angular velocity were analyzed, included flexion extension ratio(F/E), peak torque(PT) and average power(AP). The spinal symmetry was also analyzed, included RA, M and LR. The postoperative patients were evaluated by Oswestry disability index(ODI) score and MacNab criteria. Results: There was no significant difference in preoperative indexes between the two groups(P＞0.05). The postoperative F/E[(72.16±20.17)％], PT(86.54±15.39Nm) and AP(43.27±15.68W) of observation group obviously improved compared with that preoperatively[(86.59±23.46)%, 72.10±16.39Nm and 28.41±16.34W](P＜0.05), and there was significant difference compare with that of the control group[(79.64±21.40)%, 80.14±15.64Nm and 37.69±14.38W](P＜0.05). RA, M and LR were lower in observation groups than those in control group after operation(P<0.05). The two groups of patients were followed up for 12 months respectively. The postoperative ODI values of the two groups of patients were reduced, with that of observation group lower than that of control group(P<0.05); the control group was followed up for 6 months and 12 months. They were 67.69% and 72.31%. At 6 months and 12 months follow-up, the excellent and good rates according to the MacNab standard in the control group were 67.69% and 72.31%, and in the observation group were 87.69% and 93.85%, respectively. The difference between the two groups was statistically significant(P<0.05). Conclusions: Modified percutane-ous transforaminal spine endoscopy has high application value in the treatment of elderly patients with lumbar disc herniation judged by biomechanical properties of the back muscles and spinal symmetry, and the ODI score and the MacNab criteria were superior to fenestration discectomy.