Percutaneous transforaminal endoscopic discectomy versus microendoscopic discectomy for upper lumbar disc herniation: a retrospective comparative study

摘要

Background: The present study aimed to investigate the clinical outcomes of percutaneous transforaminal endoscopic discectomy (PTED) and microendoscopic discectomy (MED) in the treatment of upper lumbar disc herniation (ULDH). Methods: A total of 62 ULDH patients treated with PTED or MED were enrolled in this study and were randomly divided into group A (PTED, n=31) and group B (MED, n=31). The characteristics, surgical duration, incision length, blood loss, volume of drainage, length of hospital stay, and the complications and recurrences of patients were recorded and compared between the two groups. The Japanese Orthopedic Association (JOA), Oswestry Disability Index (ODI), and visual analogue scale (VAS) scores were compared preoperatively, postoperatively, and at the final follow-up between group A and group B. The postoperatively clinical outcomes of patients were evaluated according to the modified MacNab criterion. Results: The incision length, the duration of surgery, intraoperative blood loss, volume of drainage, and length of hospital stay in group A were less than those in group B (P<0.01). Compared with group B, the JOA scores of the patients in group A were significantly enhanced at 1 month (P<0.01), 3 months (P<0.01), and 6 months (P<0.01), the VAS scores were significantly improved at 1 month (P<0.01), 3 months (P<0.01), 6 months (P<0.05), and 12 months (P<0.05), and the ODI scores exhibited significant improvements at 1 month (P<0.01) and 3 months (P<0.05). Conclusion: PTED provides better results in the treatment of ULDH compared with MED. It is beneficial to improve the quality of life of patients and is worthy of promotion in clinical application.