Aim:To introduce and evaluate the efficacy of the trans-superior articular process (trans-SAP) approach utilizing visual trephine in PETLD for migrated lumbar disc herniation.
Material and Methods:This study included 98 patients, 50 patients were in trans-SAP PETLD group and 48 patients were in conventional PETLD group. Visual analogue scale (VAS), Oswestry disability index (ODI), gender, age, blood loss, operation time, the frequency of X-ray fluoroscopy and the percentage of highly migrated herniation were evaluated and compared between the trans-SAP PETLD and conventional PETLD group.
Results:In both the trans-SAP PETLD and conventional PETLD group, VAS and ODI were decreased at postoperative 1 day and 3 months compared preoperative (P<0.001). What\'s more, the VAS and ODI of postoperative 3 months were lower than the postoperative 1 day (P<0.001). There was no difference in gender, age, blood loss after the operation, VAS during operation between trans-SAP group and conventional group(P>0.05). The blood loss during the operation of the trans-SAP group was higher (P<0.05), but the operation time and frequency of X-ray fluoroscopy were lower than the conventional group (P<0.001). Last, the trans-SAP group had a higher percentage of highly migrated herniation (P<0.001).
Conclusion:Both the conventional way and trans-SAP approach can achieve excellent surgical results. But, in the trans-SAP group, the operation time is shorter, and X-ray fluoroscopy is less. PETLD with visual trephine has more advantages in highly migrated herniation and maybe easier to be mastered by young surgeons.