Affiliation:
1. Department of Spine Surgery The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University Luzhou China
2. Department of Spine Surgery The Nanjing TCM Hospital Affiliated to Nanjing University of Traditional Chinese Medicine Nanjing China
3. Division of Spine Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University Nanjing China
Abstract
ObjectiveCurrently, there is no established guideline on whether to opt for percutaneous endoscopic lumbar discectomy (PELD) or traditional transforaminal lumbar interbody fusion (TLIF) surgery based on specific types of lumbar disc herniation (LDH). Based on the Michigan State University (MSU) classification system, this study conducted a medium‐ to long‐term follow‐up analysis of two surgical methods over 5 years for the first time, aiming to provide empirical evidence to assist in making more informed decisions before surgery for LDH treatment.MethodsThis was a retrospective study that included 273 patients with single‐level LDH who underwent PELD or TLIF treatment at our hospital between January 1, 2016, and December 31, 2018. Detailed metrics included preoperative and postoperative visual analogue scale (VAS) scores and Oswestry disability index (ODI) at 1‐day, 1‐week, 1‐year, and 5‐year follow‐ups. Complications, recurrences, and 5‐year postoperative modified MacNab criteria scores were also recorded. Statistical methods included independent sample t‐tests, repeated measures analysis of variance (ANOVA), and χ2 tests.ResultsClassified into seven groups according to the MSU classification, it was found that there was an improvement in the VAS and ODI scores at four postoperative follow‐ups (p < 0.001). PELD showed better results than TLIF in reducing pain and improving the ODI scores in the classifications of 3B, 2B, and 2C (p < 0.05). TLIF demonstrated consistent superiority over PELD in 2A, 2AB, 3A, and 3AB classifications (p < 0.05). The total recurrence rate in the PELD group (11.05%) within 5 years after surgery was higher (p < 0.05) than that in the TLIF group (3.96%). These were mainly concentrated in the 2A, 2AB, 3A, and 3AB types. Moreover, the rate of excellent and good outcomes in the PELD was higher than in the TLIF but no significant difference (χ2 = 1.0568, p = 0.5895).ConclusionThis study suggests that PELD and TLIF may relieve LDH, but have advantages under different MSU classifications. The MSU classification has specific guiding significance and could aid in the surgical selection of PELD or TLIF to achieve optimal treatment outcomes for patients with lumbar disc herniation.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献