Application Research of PETD Combined with MRI Nerve Root Water Imaging in the Minimally Invasive Treatment of LDH
- 1 Wenzhou Combined Traditional Chinese and Western Medicine Hospital of Zhejiang Chinese Medicine University, Wenzhou, China
- 2 The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
- 3 The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
- 4 Wenzhou Combined Traditional Chinese and Western Medicine Hospital of Zhejiang Chinese Medicine University, Wenzhou, China
- 5 Wenzhou Combined Traditional Chinese and Western Medicine Hospital of Zhejiang Chinese Medicine University, Wenzhou, China
- 6 Wenzhou Combined Traditional Chinese and Western Medicine Hospital of Zhejiang Chinese Medicine University, Wenzhou, China
- 7 Wenzhou Combined Traditional Chinese and Western Medicine Hospital of Zhejiang Chinese Medicine University, Wenzhou, China
Abstract
<b>Objectiv</b><b>e:</b> This study aims to evaluate the safety and efficacy of PETD combined with nerve root water imaging of MRI for the treatment of lumbar disc herniation. <b>Method</b><b>s: </b>A retrospective review was performed on 62 patients with lumbar disc herniation from March 2019 to March 2021. The study included an experimental group of 30 patients and a control group of 32 patients. The experimental group underwent PETD combined with nerve root water imaging of MRI, while the control group received traditional PETD treatment. The visual analogue scoring method (VAS score), and JOA lumbar spine function score before and after surgery were compared between the two groups, and efficacy was assessed and compared using the MacNab score. <b>Resul</b><b>ts:</b> The mean operation time was significantly reduced in the experimental group (56.43 &#177; 10.40 minutes) compared to the control group (65.69 &#177; 14.12 minutes). The VAS score was compared between the two groups with preoperative (p = 0.624), one month after surgery (p = 0.325), three months after surgery (p = 0.676), one year after surgery (p = 0.341); The JOA score was compared between the two groups with preoperative (p = 0.961), one month after the surgery (p = 0.266), three months after surgery (p = 0.185), one year after surgery (p = 0.870), they were no significant statistical difference; The efficacy evaluation of the last follow-up Macnab showed that all the 30 patients in the experimental group were excellent, 31 of 32 patients in the control group were excellent, 1 case was good; There was no statistical difference in the comparison between the two groups (p > 0.05). <b>Conclusio</b><b>n: </b>The study concludes that the combined approach of PETD with nerve root water imaging of MRI is a safe, effective, and more efficient alternative to conventional PETD for treating lumbar disc herniation.
- Amin, R.M., Andrade, N.S. and Neuman, B.J. (2017) Lumbar Disc Herniation. Cu r rent Reviews in Musculoskeletal Medicine , 10, 507-516. https://doi.org/10.1007/s12178-017-9441-4
- Gibson, J.N., Grant, I.C. and Waddell, G. (1999) The Cochrane Review of Surgery for Lumbar Disc Prolapse and Degenerative Lumbar Spondylosis. Spine ( Phila Pa 1976), 24, 1820-1832. https://doi.org/10.1097/00007632-199909010-00012
- Hoogland, T., van den Brekel-Dijkstra, K., Schubert, M and Miklitz, B. (2008) Endoscopic Transforaminal Discectomy for Recurrent Lumbar Disc Herniation: A Prospective, Cohort Evaluation of 262 Consecutive Cases. Spine ( Phila Pa 1976), 33, 973-978. https://doi.org/10.1097/BRS.0b013e31816c8ade
- Li, K., Li, Z., Geng, W., Wang, C. and Ma, J. (2016) Postdural Disc Herniation at L5/S1 Level Mimicking an Extradural Spinal Tumor. European Spine Journal , 25, 80-83. https://doi.org/10.1007/s00586-015-4125-5
- Byun, W.M., Jang, H.W. and Kim, S.W. (2012) Three-Dimensional Magnetic Resonance Rendering Imaging of Lumbosacral Radiculography in the Diagnosis of Symptomatic Extraforaminal Disc Herniation with or without Foraminal Extension. Spine ( Phila Pa 1976), 37, 840-844. https://doi.org/10.1097/BRS.0b013e3182374465
- Jia, J., Wei, Q., Wu, T., He, D. and Cheng, X. (2018) Two Cases in Which 3D MRI Was Used to Differentiate between a Disc Mass That Mimics a Tumor and Neurinoma. BMC Musculoskeletal Disorders , 19, Article No. 154. https://doi.org/10.1186/s12891-018-2070-2
- Liu, X., Yuan, S., Tian, Y., et al . (2018) Comparison of Percutaneous Endoscopic Transforaminal Discectomy, Microendoscopic Discectomy, and Microdiscectomy for Symptomatic Lumbar Disc Herniation: Minimum 2-Year Follow-up Results. Journal of Neurosurgery : Spi ne , 28, 317-325. https://doi.org/10.3171/2017.6.SPINE172
- Ruan, W., Feng, F., Liu, Z., Xie, J., Cai, L. and Ping, A. (2016) Comparison of Percutaneous Endoscopic Lumbar Discectomy versus Open Lumbar Microdiscectomy for Lumbar Disc Herniation: A Metaanalysis. International Journal of Surgery , 31, 86-92. https://doi.org/10.1016/j.ijsu.2016.05.061
- Schubert, M. and Hoogland, T. (2005) Endoscopic Transforaminal Nucleotomy with Foraminoplasty for Lumbar Disk Herniation. Operative Orthopädie und Traum a tologie , 17, 641-661.
- Wang, H., Huang, B., Li, C., e t al . (2013) Learning Curve for Percutaneous Endoscopic Lumbar Discectomy Depending on the Surgeon’s Training Level of Minimally Invasive Spine Surgery. Clinical Neurology and Neurosurgery , 115, 1987-1991. https://doi.org/10.1016/j.clineuro.2013.06.008