Effects analysis of massive sequestrated prolapse of lumbar disc herniation assisted by microscope via fixed channel

Objective To investigate the clinical effect of microscope assisted by fixed channel on the treatment of massive sequestrated prolapse of lumbar disc herniation. Methods From August 2016 to April 2017, 36 patients of massive sequestrated prolapse of lumbar disc herniation in the Department of Spinal Surgery of the First Affiliated Hospital of Dalian Medical University were treated with microscope assisted by fixed channel. Among them, there were 21 males and 15 females, aged 21-58 years, with an average of 37 years. Segment L3/4: 7, L4/5: 19 and L5/S1: 10. The clinical efficacy was evaluated by pain visual analogue score (VAS), Oswestry dysfunction index (ODI) and improved MacNab. Results The operation was performed successfully for all the patients. The mean operation time was (45±9) min, and the average bleeding amount was 20 mL. The average frequency of fluoroscopy was 3 times in each operation. Dysfuncton of stool, sensory disturbance, muscle weakness, and low back and leg pain were alleviated in different degrees after the operation in all the patients. Preoperative, postoperative 1 day, 1 month, 3 months, and 6 months back pain VAS scores were 5.8±1.2, 1.8±0.8, 1.2±0.6, 0.6±0.3, and 0.5±0.3, respectively. Leg pain scores were 7.8±1.2, 2.8±0.6, 1.7±0.4, 0.7±0.2, and 0.6±0.1 points, respectively. The ODI indexes were 52.57%±9.21%, 34.27%± 7.58%, 24.45%±6.78%, and 12.56%±5.21%, respectively. Statistically significant differences existed in the VAS and ODI scores preoperatively and in the corresponding follow-up time (all P values<0.01). The improved MacNab was evaluated at the last follow-up, with a good rate of 94.4%(34/36). Conclusions The treatment of massive sequestrated prolapse of lumbar disc herniation assisted by microscope via fixed channel has advantages of less trauma, less bleeding and less intraoperative fluoroscopy. Its short-term curative effect is accurate. Long-term results need further follow-up. Key words: Intervertebral disc displacement; Lumbar vertebrae; Microscope; Minimally invasive