Effects of different anesthesia methods on postoperative transient neurological syndrome in patients with lumbar disc herniation

摘要

The objective of the present study was to investigate the effects of different anesthesia methods on postoperative transient neurologic syndrome (TNS) in patients with lumbar disc herniation (LDH). Ninety-six patients with LDH were selected from November 2015 to October 2016 in Cangzhou Central hospital. All patients were treated with percutaneous transforaminal endoscopic discectomy. The patients were randomly divided into the control group and observation group, with 48 patients each. Combined spinal-epidural anesthesia was performed for patients in the control group, while epidural anesthesia was applied in the observation group. The levels of T lymphocyte subsets (CD4(+) and CD8(+)) and inflammatory factors (IL-2 and TNF-alpha) were measured and compared before and 1 week after surgery. The incidence rate of TNS within 1 week after surgery was compared between the two groups. Fugl-Meyer Assessment was used to evaluate lower limb motor function and sensory disturbances at 1, 3 and 5 days after treatment. One week after treatment, the serum levels of CD4(+) and CD8(+) in the two groups were significantly lower than those before surgery (p 0.05). The incidence rate of TNS within 1 week after surgery was significantly lower in the observation group than in the control group (p<0.05). The scores of lower limb motor function and sensory disturbances in the observation group evaluated at 1, 3 and 5 days after treatment were significantly higher than those in the control group (p<0.05). In conclusion, combined spinal-epidural anesthesia and epidural anesthesia caused no significant differences in immune function or inflammatory indexes in patients with LDH. However, the application of epidural anesthesia significantly reduced the incidence rate of postoperative TNS, which in turn reduced nerve damage.