Purpose: This study aims to analyse 63 patients in our hospital during 2015-2017 treated by Thoracolumbar Debridement (TD), and elucidate any significant factors in operation process influencing the spinal recovery.
Methods: Different TD surgeries were performed using four surgical methods: Fenestration Discectomy (FD), Percutaneous Screw Fixation (PSF), Percutaneous Transforaminal Endoscopic Discectomy (PTED) and Percutaneous Interlaminar Endoscopic Discectomy (PIED). The spinal function was evaluated by the Japanese Orthopaedic Association (JOA) scores at three time points: the admission day, discharge day and three months after discharge.
Results: At the discharge time, the following functions were found significantly influenced by the surgical methods: daily activity limitation, standing function, setting posture, and heave function. In particular, for the standing function, the PIED had a significantly higher score than PTED. Three months later, the PSF group showed a better performance in various items regarding to the spinal function, compared to PTED. The hemorrhage volume, which was influenced by the surgical method, showed a correlation with the scores of pace, standing function, setting posture, and daily activity that more blood loss linked to poorer recovery in a short term.
Conclusions: Together, surgical methods, hemorrhage amounts and the spinal function (at the discharge time and three months later) had correlations mutually. The PSF method could still be an optimal choice for the spinal function, despite its disadvantages in the blood loss volume, compared to PTED. Hemorrhage largely influenced the spinal function recovery in the short term after operation and was strongly decided by surgical techniques during TD operation.Author(s): Zhenbin Wang, Tuerhugjan Turdi, Kahaer Aikenmu, Wenfei Gu, Laiyong Tu, Enfeng Zhang, Jiang Zhao