Treatment of lumbar intervertebral disc herniation and sciatica with percutaneous transforaminal endoscopic technique

Abstract

OBJECTIVE:

To analyze the clinical effects of percutaneous transforaminal endoscopic technique in treating lumbar intervertebral disc herniation and sciatica.

METHODS:

From June 2011 to January 2012,the clinical data of 46 patients with lumbarintervertebral disc herniation and sciatica underwent percutaneous transforaminal endoscopic technique were retrospectively analyzed. There were 28 males and 18 females,ranging in age from 11 to 77 years old with an average of (39.7_ 15.3) years old,20 cases were L5S1 and 26 cases were L4,5. All patients had the symptoms such as lumbago and sciatica and their straight-leg raising test were positive. Straight-leg raising test of patients were instantly repeated after operation;operative time,volume of blood loss,complication, length of stay and duration of back to work or daily life were recorded. The clinical effects were assessed according to the VAS,JOA and JOABPEQ score.

RESULTS:

All operations were successful,postoperative straight-leg raising test were all negative. Operative time,volume of blood loss,length of stay,duration of back to work or daily life,follow-up time were (93.0+/-28.0) min, (20.0+/-9.0)ml, (3.1+/-1.5) d, (11.6+/-4.2) d, (13.9+/-1.6) months,respectively. VAS score of lumbar before operation and at the 1st and 3rd,6th,12th month after operation were 5.3+/-1.2,1.9+/-1.1,1.0+/-0.8,0.9+/-0.8,0.8+/-0.6,respectively;VAS score of leg before operation and at the 1st and 3rd,6th,12th month after operation were 7.2+ 1.2,0.8+/-1.2,0.5+/-0.8,0.5+/-0.8,0.3+/-0.8,respectively. Five factors of JOABPEQ score,including lumbar pain,lumbar function, locomotor activity,social life viability and mental status,were respectively 27.0+/-30.6,37.3+/-27.4,38.5+/-26.6,33.0+/-13.7,55.4+/-19.0 before operation and 83.6+/-24.8,89.4+/-15.7,87.0+/-17.9,58.4+/-14.6,79.5+/-13.4 at final follow-up. Preoperative and postoperative JOA score were 9.1+/-2.6 and 27.3+/- 1.7, respectively. The postoperative VAS,JOA and JOABPEQ score had significantly improved (P<0.05).

CONCLUSION:

Percutaneous transforaminal endoscopic technique is safe and effective method in treating lumbar disc herniation and sciatica,it can fleetly relieve pain and the patient can recover daily life and work after treatment.

PMID:

 

24490523

 

[PubMed - indexed for MEDLINE]

Treatment of lumbar intervertebral disc herniation with coblation combined with ozone nucleus pulposus ablation

Abstract

OBJECTIVE:

To compare the clinical effects between coblation combined with ozone nucleus pulposus ablation and single radiofrequency ablation of nucleus pulposus in treating a simple segment inclusive lumbar intervertebral disc herniation.

METHODS:

From June 2009 to June 2011,33 patients with lumbar intervertebral discherniation were treated with coblation combined with ozone nucleus pulposus ablation (group A),including 19 males and 14 females,ranging in age from 20 to 60 years old with an average of (40.4+/-8.8) years old,in the course of disease from 12 to 38 months with an average of (19.9+/-5.8) months;31 patients were treated with single radiofrequency ablation of nucleus pulposus(group B),ineluding 18 males and 13 females,ranging in age from 20 to 60 years old with an average of (39.8+/-7.3) years old,in the course of disease from 12 to 48 months with an average of (19.2+/-8.1) months. Visual analogue score(VAS) and JOA score system was respectively used to evaluate pain and function after operation.

RESULTS:

All patients were followed up more than 1 year. No injuries of nerve root and cauda equina nerve,infection were found. There was no significant difference in VAS score between two groups at 1 month after operation (P>0.05),but at 12 months after operation,VAS score of group A was better than that of group B (P<0.05). There was no significant difference in JOA score between two groups at 12 months after operation (P>0.05). According to the functional improvement rate to evaluate the clinical effects,in group A,9 cases got excellent results, 21 good,3 fair;and in group B,6 excellent,18 good,7 fair. Clinical effects of group A was better than that of group B (P<0.05).

CONCLUSION:

Clinical effects of coblation combined with ozone nucleus pulposus ablation is better in treating a simple segment inclusive lumbar intervertebral disc herniation.

PMID:

 

24490526

 

[PubMed - indexed for MEDLINE]