METHODS: Ninety-one consecutive patients with unilateral lumbar radiculopathy and FELDH underwent paraLD. Demographic and perioperative data were collected. Clinical outcomes were evaluated using the visual analog scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI) for spinal disability, and the modified Macnab criteria for patient satisfaction. Postoperative complications and reoperation rates were also evaluated.
RESULTS: In total, 76 patients were included in the final analysis. Among them, 43 underwent BE paraLD (group A) and the remaining 33 underwent MT paraLD (group B). The demographic and preoperative data were not statistically different between the groups. All patients showed significant improvements in VAS back, VAS leg, and ODI scores compared with baseline values (p < 0.05). The improvement in VAS back scores was significantly better in group A than in group B on postoperative day 2 (p < 0.001). However, all clinical parameters were comparable between the two groups after postoperative year 1 (p > 0.05). According to the modified Macnab criteria, 86.1% and 72.7% of the patients had excellent or good outcomes in groups A and B, respectively. No intergroup differences were observed (p = 0.367). In addition, there were no differences in the total operation time or amount of surgical drainage. Postoperative complications were not significantly different between the two groups (p = 0.301); however, reoperation rates were significantly higher in group B (p = 0.035).
CONCLUSIONS: BE paraLD is an effective treatment for FELDH and is an alternative to MT paraLD. In particular, BE paraLD has advantages of early improvement in postoperative back pain and low reoperation rates.
方法:91例单侧腰椎神经根病和FELDH患者接受paraLD治疗。收集人口统计学和围手术期数据。使用视觉模拟量表(VAS)评估背部和腿部疼痛的临床结果。脊柱残疾的Oswestry残疾指数(ODI),和改良的Macnab患者满意度标准。术后并发症和再手术率也进行了评估。
结果:总计,最终分析包括76例患者。其中,43例接受BEparaLD(A组),其余33例接受MTparaLD(B组)。两组之间的人口统计学和术前数据没有统计学差异。所有患者VAS背部均有显著改善,VAS支腿,和ODI评分与基线值相比(p<0.05)。术后第2天,A组的VAS背部评分改善明显优于B组(p<0.001)。然而,术后1年,两组患者的临床指标具有可比性(p>0.05)。根据修改后的Macnab标准,86.1%和72.7%的患者在A组和B组中有优异或良好的预后,分别。没有观察到组间差异(p=0.367)。此外,手术总时间或手术引流量无差异.术后并发症在两组间无显著差异(p=0.301);B组的再手术率明显高于对照组(p=0.035)。
结论:BEparaLD是FELDH的有效治疗方法,是MTparaLD的替代方法。特别是,BEparaLD具有早期改善术后背痛和低再手术率的优点。