There was no intraoperative death in this series. In ends 167 cases had follow-up at least one year and 22 cases lost, and the follow-up rate was 89.7% (78/87) in OL, 87.1% (54/62) in CL, and 87.5% (35/40) in TL (P > 0.05). The followed time was from 14 to 24 months (average 14 months), and average 13.16 ± 1.57 months on OL, 13.48 ± 1.62 months on CL, and 13.56 ± 1.73 months on TL patients (P > 0.05). The hospital days were no significant difference among three groups patients (3.25 ± 1.47 days in OL, 3.53 ± 1.87 days in CL, and 3.68 ± 1.69 days in TL, P > 0.05) (Table 1).
The average operational time were lest in OL patients (31.84 ± 11.73 minutes), modest in CL patients (54.68 ± 13.55 minutes), and most in TL patients (76.74 ± 12.89). However, the average times spent in every level were no significant difference among three groups (P > 0.05) (Table 1). The average blood losses were less in OL patients (21.58 ± 11.69 mL), modest in CL patients (43.72 ± 12.53 mL), and most in TL patients (62.83 ± 11.71 mL). Take into according the operational levels, the single level blood loss were no significant difference among three group patients (P > 0.05) (Table 1).
Table 1 Follow up time and operation date of patients (Means ± SD)
|
Group
|
Follow up*
|
Operation time
|
Hospital days*
|
Blood loss
|
|
Rate
|
Time (Month)
|
(Minutes)
|
(Days)
|
(mL)
|
OL
|
89.7% (78/87)
|
13.16 ± 1.57
|
31.84 ± 11.73
|
3.25 ± 1.46
|
21.58 ± 11.69
|
CL
|
87.1% (54/62)
|
13.48 ± 1.62
|
54.68 ± 13.55
|
3.53 ± 1.87
|
43.72 ± 12.53
|
TL
|
87.5% (35/40)
|
13.56 ± 1.73
|
76.74 ± 12.89
|
3.68 ± 1.69
|
62.83 ± 11.71
|
Note: OL = One level, CL = Couple level, TL = Triple level. *, no significant difference (P > 0.05)
|
The pain index improved from 8.24 ± 1.25 to 1.12 ± 0.47 (P < 0.01) in OL patients, from 8.32 ± 1.43 to 1.25 ± 0.38 (P < 0.01) in CL patients, and from 8.75 ± 1.29 to 1.48 ± 0.36 (P < 0.01) in TL patients. There were no significant difference among three groups on the average change of VAS and ODI scores (P > 0.05) (Table 2). The ODI improved from 62.55 ± 12.63 to 11.68 ± 8.54 (P < 0.01) in OL patients, from 63.57 ± 14.86 to 13.62 ± 7.76 (P < 0.01) in CL patients, and from 66.81 ± 13.49 to 12.37 ± 8.19 (P < 0.01) in TL patients.
Table 2 Clinical results date of patients (Means ± SD)
|
Group
|
OL
|
|
CL
|
|
TL
|
|
Preoperative
|
Postoperative
|
|
Preoperative
|
Postoperative
|
|
Preoperative
|
Postoperative
|
VAS
|
8.24 ± 1.25
|
1.12 ± 0.47
|
|
8.32 ± 1.43
|
1.25 ± 0.38
|
|
8.75 ± 1.29
|
1.48 ± 0.36
|
ODI
|
62.55 ± 12.63
|
11.68 ± 8.54
|
|
63.57 ± 14.86
|
13.62 ± 7.76
|
|
66.81 ± 13.49
|
12.37 ± 8.19
|
DH (mm)
|
8.79 ± 2.45
|
8.62 ± 2.47
|
|
8.54 ± 2.51
|
8.38 ± 2.46
|
|
8.47 ± 2.69
|
8.33 ± 2.75
|
FH (mm)
|
13.54 ± 1.82
|
13.42 ± 1.94
|
|
13.49 ± 1.77
|
13.25 ± 1.58
|
|
13.37 ± 1.68
|
13.15 ± 1.72
|
Note: OL = One level, CL = Couple level, TL = Triple level. DH = Disk height, FH = Foramen height.
|
The average disk space height decreased from preoperative 8.79 ± 2.45 mm in preoperatively to 8.62 ± 2.47 mm in postoperatively in OL patients (P > 0.05), and from 8.54 ± 2.51 mm to 8.38 ± 2.46 mm in CL patients (P > 0.05), and from 8.47 ± 2.69 mm to 8.33 ± 2.75 mm in TL patients (P > 0.05). There were no significant difference among three groups on the average change of disk height and intervertebral foramen height (P > 0.05). The mean foramen height decreased form 13.54 ± 1.82 mm in preoperatively to 13.42 ± 1.94 mm in postoperatively in OL patients (P > 0.05), and from 13.49 ± 1.77 mm to 13.25 ± 1.58 mm in CL patents (P > 0.05), and from 13.37 ± 1.68 mm to 13.15 ± 1.721 mm in TL patents (P > 0.05) (Table 2).
All patients achieved pain free accomplished all surgery procedures, no infection, and no dural tear of cerebrospinal fluid leakage complication. On the Mac Nab criteria, there were no significant difference of good or excellent among three group patients (83.5% in OL, 83.5% in CL, and 84.6% in TL, P > 0.05). There were 27 cases of excellent, 10 cases of good, 5 cases of general, and 0 cases of poor in CL group; 28 cases of excellent, 11 case of good, 5 case of general, and 0 cases of poor in OL, and 28 cases of excellent, 11 case of good, 5 case of general, and 0 cases of poor in TL. There was one case in the OL group had L3/4 percutaneous endoscopic surgery with the needle broken in muscle when procedure. The partial needle had been moved by the percutaneous procedure. The surgery was performed and the clinical outcome of this case is good, and no complication. (Figure 3)
Figure 3 Shows the case of L3/4 percutaneous endoscopic surgery had the needle broken in muscle when procedure. The partial needle had been moved by the percutaneous procedure. The surgery was performed and the clinical outcome of this case is good, and no complication.