KẾT QUẢ ĐIỀU TRỊ THOÁT VỊ ĐĨA ĐỆM CỘT SỐNG L5S1 BẰNG GIẢI ÉP VI PHẪU TẠI BỆNH VIỆN VIỆT ĐỨC

Abstract

Objectives: Evaluate the outcomes of microdiscectomy treatment for lumbar disc herniation at the L5-S1 level. Objects and Methods: A longitudinal descriptive and prospective study on 42 patients with microdiscectomy treatment for lumbar disc herniation at the L5-S1 level. Results: 42 patients, the male-to-female ratio was 1.08:1, with an average age of 44.89 ± 9.34, ranging from 24 to 78 years. Clinical symptoms included radicular pain in all 42 patients (100%), low back pain in all 42 patients (100%), and positive femoral nerve strectch test in 39 patients (92.9%). Motor function impairment was observed in 1 patient (2.4%), and reduced tendon reflex in 12 patients (28.6%). The average preoperative VAS score was 7.58 ± 1.32. The average preoperative ODI score was 69.36 ± 7.42, with 92% of patients experiencing severe spinal dysfunction from grade III and above. Radiological features on MRI: disc herniation classification in axial revealed 25 patients with left-sided herniation (59.5%) and 17 patients with right-sided herniation (40.5%). The herniation location showed 37 patients with foraminal herniation (88.1%) and 7 patients with extraforaminal herniation (11.9%). Migration of disc herniation was observed in 22 patients, predominantly extruded migration accounting for 52.4%. Surgical details included an average operation time of 52.46 ± 10.48 minutes, an average blood loss of 124.52 ± 34.7 ml, and an average hospital stay of 5.75 ± 1.32 days. Intraoperative complications included one patient with dural tear (2.4%). Postoperative complications comprised one patient with local infection (2.4%). Surgical outcomes: Both VAS and ODI scores significantly improved at 1 and 6 months postoperatively, with a statistically significant difference (p < 0.001). MacNab was rated as good or excellent in 42 patients (95.2%). Conclusion: Microdiscectomy treatment for L5S1 lumbar disc herniation achieves favorable results with significantly improved clinical symptoms and low rates of complications and adverse events.