Comparison of tissue damages caused by endoscopic lumbar discectomy and open lumbar discectomy
PAN Lei, YIN Qing-Shui
Chinese Journal of Clinical Anatomy ›› 2013, Vol. 31 ›› Issue (5) : 596-599.
Comparison of tissue damages caused by endoscopic lumbar discectomy and open lumbar discectomy
Objective The purpose of this study is to compare the overall effects of surgical trauma and surgical results resulting from PELD and OD. Methods The patients were randomly allocated into two groups, the PELD and OD groups. Each group contained 10 patients. Blood loss, hospital stay, and skin incision size will be recorded in these two groups. In this study, a quantitative comparison will be performed through analysis of patient's systemic cytokines, CPK and CRP response. An enzyme-linked immunosorbent assay (ELISA) was used for serum levels of Interleukin-1beta(IL-1), Interleukin-6 (IL-6), and Interleukin-8 (IL-8), Interleukin- 10(IL-10) and were measured before surgery and at 1,6,12 ,24 and 48 hours after surgery. Serum C-reactive protein (CRP) and creatine phosphokinase (CPK) were measured at the same time interval. Results The overall results showed PELD group had less blood loss ( P＜0.01), less hospital stay(P＜0.01), less skin incision size(P＜0.01) than OD group. Using the modified MacNab criteria, the clinical outcomes were 90% in PELD and OD group at the postoperative 6-month follow up. CRP、 CPK、IL-6 level showed significant difference at 24 hours and 48 hours between the two groups (P＜0.01). The systemic IL-6, CRP and CPK were significantly less following PELD than OD. Conclusion PELD offers a similar short-term clinical outcome，with smaller incision，less tissue trauma and quicker recovery than OD.
Percutance / Endoscopic lumbar discectomy / Open discectomy / Lumbar disc herniation / Systemic cytokines
[1] Nellensteijin J, Ostelo R, Bartels R,et al. Transforaminal endoscopic surgery for symptomatic lumbar disc herniations:a systematic review of the literature
[J]. Eur Spine J, 2010, 19(2):181-204.
[2] Karnezis IA. Minimally invasive therapeutic interventional procedures in the spine:an evidence-based review
[J]. Surg Technol Int, 2008,17:259-268.
[3] Ozaktay AC, Kallakuri S, Takebayashi T, et al. Effects of interleukin-1 beta, interleukin-6, and tumor necrosis factor on sensitivity of dorsal root ganglion and peripheral receptive fields in rats
[J]. Eur Spine J,2006,15(10):1529-1537.
[4] Yan HQ, Banos MA, Herregodts P, et al. Expression of interleukin (IL)-1 beta, IL-6 and their respective receptors in the normal rat brain and after injury
[J]. Eur J Immunol,1992,22(11):2963-2971.
[5] Abbadie C, Lindia JA, Cumiskey AM, et al. Impaired neuropathic pain responses in mice lacking the chemokine receptor CCR2
[J]. Proc Natl Acad Sci USA, 2003,100(13): 7947-7952.
[6] Milligan ED, Twining C, Chacur M, et al. Spinal glia and proinflammatory cytokines mediate mirror-image neuropathic pain in rats
[J].J Neurosci, 2003,23(3):1026-1040.
[7] Cavanaugh JM. Neural mechanisms of lumbar pain
[J]. Spine, 1995,20:1804-1809.
[8] Ng CY, Gibson JNA. An aid to the explanation of surgical risks and complications: the Internations Sheet(ISSiS)
[J]. Spine, 2011, 36(26):2333-2345.
[9] Huang TJ, Hsu RW, Li YY, et al. Less systemic cytokine response in patients following microendoscopic versus open lumbar discectomy
[J]. OrthopRes, 2005, 23(2): 406-411.
[10] 刘文和, 李康华, 陈立科, 等. 腰椎间盘微创外科围手术期应激反应.
[J] 湘南学院学报(自然版), 2004, 6(1): 1-3.
[11] Datta G, Gnanalingham KK, Peterson D, et al. Back pain and disability after lumbar laminectomy: is there a relationship to muscle retraction
[J]. Neurosurgery, 2004, 54(6): 1413-1420.
[12] Schick U, Dohnert J, Richter A, et al. Microendoscopic lumbar discectomy versus open surgery: an intraoperative EMG study
[ J]. Eur Spine, 2002, 11(1): 20-26.
/
| 〈 |
|
〉 |
