Discography in Percutaneous Endoscopic Lumbar Discectomy Treatment of Multiple Lumbar Disc Herniation

LI Tao; XU Feng; XU Bin; ZHANG Tong-hui

doi:10.13730/j.issn.1009-2595.2017.05.004

Abstract：Objective To discuss the discography's clinical value in the percutaneous endoscopic lumbar discectomy (PELD) treatment of lumbar disc herniation, provide new ideas on clinical treatment of lumbar disc herniation.Methods From October 2013 to February 2015, 31 patients were diagnosed and treated with PELD surgery,there were 13 females and 18 males,aged 23-55 years, mean 40 years, while L3~4 and L4~5 protruding in 9 cases, L3~4 and L5~S1 protruding in 5 cases, L4~5 and L5~S1 protruding in 15 cases, L2~3 and L5~S1 protruding in 1 case,L2~3, L3~4 and L5~S1 protruding in 1 case.All patients were confirmed by discography, the segments of positive symptoms accepted PELD surgery.Using visual analogue scale (VAS) and modified MacNab criteria for therapeutic effect evaluation.Results Thirty-one patients conducted a total of 63 times disc puncture angiography, 16 cases were single-gap positive, 15 cases were double gap positive, no one was three gap positive, 46 segments implemented PELD surgery, all patients were successfully completed.Operation time were 70-155 minutes, average 113 minutes,bleeding 7-25ml, average blood loss was 15ml, all patients were followed up for 12-44 months, an average of 25.5 months.Postoperative VAS scores at 3 days, 3, 12 months with preoperative VAS score were significantly different (P<0.01), 3, 12 months VAS scores after surgery and postoperative VAS scores at 3 days were significantly different (P<0.01),12 months VAS score had no significant difference with 3 months VAS score (P>0.05), the excellent and good rate was 93.55%.Conclusion Discography combined PELD treatment of multiple lumbar disc herniation has a curative effect,and provide a new way of thinking on the clinical treatment of lumbar disc herniation.