关键词: 腰椎间盘突出症； 椎间孔镜； 关节突可视化成型术； 显微镜微创通道技术；组织创伤； 红细胞免疫

Abstract: Objective To explore the impact of Video-Assisted Protrusion Treatment with Endoscope (VPTED) on red blood cell immunity,complications,and lumbar extensor muscle groups in patients with lumbar disc herniation (LDH).Methods A total of 103 LDH patients in our hospital from March 2021 to March 2023 were prospectively selected. Among them, 6 cases were lost to follow-up, and 97 cases were included in the study. They were divided into the observation group (49 cases) and the control group (48 cases) by random number table method, and VPTED and microscopic minimally invasive channel technique (MITM) were performed respectively.The perioperative indicators, complications, and excellent and good rates of the two groups were statistically analyzed. The tissue trauma indicators interleukin-6 (IL-6),IL-8,IL-17, red blood cell immune indicators, Oswestry disability index (ODI), and biomechanical indicators of the lumbar and dorsal extensor muscle group (peak moment, average power, and lumbar and dorsal flexion and extension ratio in the lumbar and dorsal extension state) before and after the operation were compared between the two groups.Results The surgical time,mobilization time,and hospitalization time of the observation group were (68.62±5.59) minutes,(1.44±0.31) days,and (7.24±1.08) days,respectively,which were shorter than those of the control group [(94.11±10.34) minutes,(2.38±0.46) days,and (9.26±1.23) days].The intraoperative blood loss and VAS scores at 3 and 5 days after surgery were (12.68±2.37) ml,(2.78±0.34)points and (1.45±0.33) points,respectively.Which were lower than those of the control group [(50.54±4.49) ml,(3.31±0.36)points and (2.12±0.40) points](P<0.05).The incision length of the observation group was (0.87±0.21)cm, which was shorter than that of the control group [(1.23±0.26)cm]. There was a statistically significant difference between the two groups (P < 0.05).From pre-operation to 7 days post-operation,the levels of IL-6,IL-17,IL-8,and RBC-ICR in both groups exhibited an increase-decrease trend,while RBC-C3bRR and RBC-NTFR showed a decrease-increase trend (P<0.05).From pre-operation to 12 months post-operation,the ODI index and lumbar back flexion-extension ratio in both groups decreased with time,while peak torque and average power in lumbar back extension increased with time (P<0.05).At 12 months post-operation,there were no statistically significant differences in complication rates (2.04% vs 6.25%) and surgical excellence rates (89.80% vs 87.50%) between the two groups (P>0.05).Conclusion VPTED is safe and effective in the treatment of LDH,and has unique advantages in the improvement of perioperative indexes.

Key words: lumbar disc herniation;foraminoscope;articular process visualization;microscopical minimally invasive channel technique;tissue trauma;erythrocyte immunity