gms | German Medical Science

Objective: To discuss the efficacy, advantages and disadvantages of percutaneous endoscopic lumbar discectomy combined with TTL dynamic fixation through Wiltse approach for lumbar disc herniation with moderate back pain.

Method: 5 cases who had lumbar disc herniation with moderate back pain underwent percutaneous endoscopic lumbar discectomy combined with TTL dynamic fixation through Wiltse approach as study group and these patients underwent continual epidural anesthesia combined with local anesthesia intra-operatively. 20 cases who had lumbar disc herniation with moderate back pain underwent traditional open lumbar discectomy combined with TTL dynamic fixation through mid-line approach as control group and these patients underwent general anesthesia intra-operatively. Comparing and analyzing operation time, intra-operative blood loss, VAS of back pain and leg pain pre- and post-operative and the results of clinical and radiographic at follow-up.

Results: In the study group, the mean operation time was 105 ± 20 min, mean intra-operative blood loss was 30 ± 10 ml, mean VAS of pre-operative leg pain was 6.2 ± 0.3, mean VAS of pre-operative back pain was 6.9 ± 0.4 and the mean post-operative hospital stay was 3 days. In the control group, the mean operation time was 124 ± 25 min, mean intra-operative blood loss was 160 ± 70 ml, mean VAS of pre-operative leg pain was 6.4 ± 0.5, mean VAS of pre-operative back pain was 6.3 ± 0.4 and the mean post-operative hospital stay was 5 days.

Conclusions: Percutaneous endoscopic lumbar discectomy combined with TTL dynamic fixation through Wiltse approach is a safe and reliable method for the treatment for lumbar disc herniation with moderate back pain. There was no significant difference in the results of both two groups and this new technique has more advantages than traditional surgery such as less damage to the paraspinal muscles, less blood loss, shorter recovery time and shorter hospital stay.