Clinical effect analysis of microscope-assisted nuclear pulposus excision under three working channels for lumbar 5 / sacral 1 disc herniation in young adults
Journal Title: Journal of Air Force Medical University - Year 2023, Vol 44, Issue 6
Abstract
Objective To compare the efficacy of three working channels in the treatment of lumbar 5 / sacral 1 disc herniation. Methods The clinical data of 113 patients with lumbar disc herniation admitted to Xijing Hospital of Air Force Medical University from March 2017 to January 2020 were retrospectively analyzed, with 37 cases of traditional simple nucleus pulposus removal ( traditional group), 42 cases of simple nucleus pulposus removal under Quadrant channel ( Quadrant group), and 34 cases of precise open-window nucleus pulposus removal under Zista fixed channel (Zista group). All patients were followed up for 1 year, and different indicators were compared and analyzed among the three groups, such as the length of surgical incision, intraoperative blood loss, postoperative drainage volume, visual analogue scale ( VAS) scores of low back pain and leg pain, and lumbar Oswestry Disability Index ( ODI). Results The length of surgical incision, intraoperative blood loss and postoperative drainage volume in the Zista group were significantly lower than those in the Quadrant group and the traditional group (P < 0. 05), while the Quadrant group was better than the traditional group (P < 0. 05). The VAS scores of low back pain in the Zista group and the Quadrant group were superior to the traditional group ( P < 0. 05 ) 7 d after surgery. At 1 year after surgery, the Zista group was superior to the Quadrant group (P < 0. 05), while the Quadrant group was comparable to the traditional group (P > 0. 05). The VAS scores of leg pain in the three groups were similar 7 d and 1 year after surgery (P > 0. 05). The ODI score of the Zista group was better than that in the Quadrant group and the traditional group 7 d after surgery (P < 0. 05), while the Quadrant group and the traditional group were similar (P > 0. 05), and the Zista group was superior to the Quadrant group 1 year after surgery (P < 0. 05) and it was further better than the traditional group ( P < 0. 05). Conclusion All the three surgical approaches can achieve relatively satisfactory clinical efficacy, while the Quadrant group shows better short-term postoperative improvement than the traditional group, and the overall therapeutic effects of the Zista group are better than the Quadrant group and the traditional group, which is worthy of promotion.
Authors and Affiliations
WANG Dong, ZHAO Lanfu, DING Ziyi, SHI Quan, ZHANG Shilei, GAO Bo, LIU Zhibin, YAN Ming
Keywords
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