Clinical effect of percutaneous transforaminal endoscopic discectomy and fenestration discectomy on the treatment of lumbar intervertebral disc in obese patients
Department of Spinal Surgery, the Third Hospital of Hebei Medical University, Key Laboratory of Orthopedic Biomechanics Hebei, Shijiazhuang 050051, China
Abstract：Objective To investigate the clinical curative effect of percutaneous transforaminal endoscopic discectomy[ tansforaminal endoscopic spine system(TESSYS )] and traditional fenestration discectomy on the treatment of lumbar intervertebral disc in obese patients(BMI≥28 kg/m2).Methods The clinical data of 36 cases of obesity patients with lumbar disc herniation from June 2013 to September 2014 in Spinal Surgery of the Third Hospital of Hebei Medical University were retrospectively analyzed. They were divided into 2 groups, open operation group (n=20) and TESSYS group (n=16).The clinical efficacy of signs and symptoms were assessed using the visual analog scale (VAS) and modified MacNab evaluation criteria, operation time, intraoperative bleeding volume, postoperative hospital stay, length of incision, and postoperative complications were compared between 2 groups.Results The average follow-up duration was 13.6 months with range from 12 to 20 months. In TESSYS group, the operation time, intraoperative bleeding volume, postoperative hospital stay, and length of incision were significantly smaller than those in the open operation group (all P values<0.01). There was no significant difference in preoperative back pain VAS scores and leg pain VAS scores between 2 groups (all P values>0.05). The postoperative back pain VAS scores and leg pain VAS scores were significantly improved compared with preoperative in the two groups,with significant difference (all P values<0.05). Twenty-four hours, 3 months, 6 months and 12 months after postoperative back pain VAS scores and leg pain VAS scores between the two groups were statistically different(all P values<0.05). Two groups of patients assessed in accordance with the results of modified MacNab evaluation criteria: excellent in12 patients, good in 6, fair in 2 respectively in open operation group, with the good to excellent results rate of 90.0%(18/20); excellent in10 patients, good in 4, fair in 2 respectively in TESSYS group,with the good to excellent results rate of 14/16. There was no significant difference between the two groups before the operation(P=1.000). The postoperative complication rate was 15.0%(3/20)and 2/16 in open operation group and TESSYS group. There was no significant difference between the two groups before the operation(P=1.000).Conclusions Percutaneous transforaminal endoscopic discectomy (TESSYS) has significant advantages in terms of operative time, intraoperative bleeding volume, relieve low back pain. It is an effective surgery for the treatment of lumbar intervertebral disc in obese patients.
张鑫,张为,孙亚澎,徐佳欣,薛睿,申勇,丁文元. 经皮椎间孔镜与椎板开窗髓核摘除手术治疗肥胖患者腰椎盘突出症的临床疗效比较[J]. 中华解剖与临床杂志, 2016, 21(5): 442-447.
Zhang Xin, Zhang Wei, Sun Yapeng, Xu Jiaxin, Xue Rui, Shen Yong, Ding Wenyuan.. Clinical effect of percutaneous transforaminal endoscopic discectomy and fenestration discectomy on the treatment of lumbar intervertebral disc in obese patients. Chinese Journal of Anatomy and Clinics, 2016, 21(5): 442-447.
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2016, Vol. 21 
