Percutaneous Endoscopic Transforaminal Discectomy versus Conventional Open Lumbar Discectomy for Upper Lumbar Disc Herniation: A Comparative Cohort Study

被引:35
|
作者
Li, Ziquan [1 ]
Zhang, Cong [2 ]
Chen, Weisheng [3 ]
Li, Shugang [1 ]
Yu, Bin [1 ]
Zhao, Hong [1 ]
Shen, Jianxiong [1 ]
Zhang, Jianguo [1 ]
Wang, Yipeng [1 ]
Yu, Keyi [1 ]
机构
[1] Peking Union Med Coll & Chinese Acad Med Sci, Dept Orthoped Surg, Peking Union Med Coll Hosp, Beijing 100730, Peoples R China
[2] China Japan Friendship Hosp, Dept Endocrinol, Beijing 100029, Peoples R China
[3] Shanghai Jiao Tong Univ, Affiliated Peoples Hosp 6, Dept Orthoped Surg, Shanghai 200233, Peoples R China
基金
中国国家自然科学基金;
关键词
INTERBODY FUSION; MICRODISCECTOMY; OUTCOMES;
D O I
10.1155/2020/1852070
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
Background. Percutaneous endoscopic transforaminal discectomy (PETD) is regarded as a viable alternative option for upper lumbar disc herniation (LDH). However, few studies have evaluated PETD for upper LDH, and no study has compared the advantages of endoscopic procedures versus conventional surgery. The present study was aimed at comparing the surgical outcome and safety of PETD versus conventional open lumbar discectomy in the treatment of upper LDH. Methods. Data from 42 patients treated for upper LDH from July 2015 to July 2018 were retrospectively analyzed, including 21 patients treated with PETD (PETD group) and 21 patients treated with conventional posterior lumbar discectomy (open group). The two groups were compared regarding demographic information, physical examination, radiological evaluations, and perioperative indicators. The clinical outcomes were assessed in accordance with the Oswestry Disability Index (ODI), visual analog scale (VAS), and modified MacNab criteria. Results. The postoperative ODI and VAS scores were significantly improved in both groups compared with the preoperative baseline values (P<0.001), and the satisfactory rate was 90.5% in both groups in accordance with the modified MacNab criteria. There were no significant differences between the two groups in the clinical outcomes and complication rate (P>0.05); however, compared with the open group, the PETD group had significantly less blood loss, less postoperative drainage, shorter operation time, and shorter postoperative hospitalization (P<0.001). Conclusions. PETD has a similar outcome to the conventional surgical method for the treatment of upper LDH but provides the typical advantages of minimally invasive procedures such as reduced iatrogenic injury, minimal activity restrictions, and accelerated ambulation recovery postoperatively.
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页数:7
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