SO SÁNH KẾT QUẢ PHẪU THUẬT LẤY THOÁT VỊ ĐĨA ĐỆM L5S1 BẰNG GIẢI ÉP VI PHẪU VÀ NỘI SOI GIAN LAM TẠI BỆNH VIỆN VIỆT ĐỨC

Abstract

Objective: To compare the surgical outcomes of microdiscectomy and interlaminar endoscopic decompression for patients with L5S1 disc herniation at Viet Duc Hospital. Methods: This is a retrospective descriptive study of 106 patients divided into two groups: Group I consisted of 48 patients with L5S1 disc herniation who underwent microdiscectomy, and Group II consisted of 58 patients with L5S1 disc herniation who underwent interlaminar endoscopic decompression at Viet Duc Hospital from June 2021 to June 2022, with a follow-up period of two years. Results: There were no differences in age, gender, or MRI characteristics of disc herniation between the two study groups. Interlaminar endoscopy showed significantly better short-term clinical outcomes compared to microdiscectomy (VAS, MacNab), but no significant differences were observed in long-term efficacy between the two methods. The hospital stay of patients in the interlaminar endoscopy group was significantly shorter than that of the microdiscectomy group (p<0.001). The complication rates of infection, reoperation, and dural tear were also lower in the interlaminar endoscopy group compared to the microdiscectomy group. There was no significant difference in the recurrence rates between the two groups. Conclusion: Interlaminar endoscopic surgery has advantages over open microdiscectomy for disc herniation removal, as it involves a smaller incision with less structural damage, resulting in minimal blood loss, shorter hospital stays, better postoperative pain relief, and fewer intraoperative and postoperative complications, leading to higher patient satisfaction. However, in terms of long-term outcomes, both interlaminar endoscopic surgery and open microdiscectomy for disc herniation removal showed no significant differences.