OBJECTIVETo provide theoretical basis for effect and mechanism of percutaneous lumbar discectomy in clinic.

METHODSA total of 180 patients with lumbar intervertebral disc herniation were evaluated by CT on the fifth day before and after operation. Meanwhile, CT value was measured in the determined level and region.

RESULTSAfter operation, CT value of the central and posterior determined point of herniated intervertebral disc was lower significantly than that before operation (P<0.01), but CT value of the anterior determined point was different insignificantly. The excellent and good results of the patients together were 83% postoperatively.

CONCLUSIONSThe curative effect of percutaneous lumbar discectomy is achieved through reduction of lumbar intradiscal pressure.

Adult ; Diskectomy, Percutaneous ; Female ; Humans ; Intervertebral Disc Displacement ; diagnostic imaging ; surgery ; Lumbar Vertebrae ; diagnostic imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

Objective:To compare the clinical outcomes of polyetheretherketone (PEEK) and titanium mesh as repair materials in the cranioplasty for cranial defect patients, and to screen the independent factors for postoperative complications of cranioplasty.Methods:A total of 95 patients with cranial defects admitted to our hospital from June 2012 to June 2019 were selected for this study. According to the different repair materials used in cranioplasty, these patients were divided into PEEK group ( n=36) and titanium mesh group ( n=59). General data (hospitalization cost, hospital stay, et al), postoperative complications (intracranial hemorrhage, subcutaneous effusion, infection, seizures, and implant exposure), postoperative plastic satisfaction, and improvement of postoperative neurological function (differences of Glasgow outcome scale [GOS] scores and Mini-mental State Examination [MMSE] scores before and 6 months after surgery) were compared between the 2 groups. Univariate and multivariate Logistic regression analyses were used to screen the independent factors for postoperative complications of cranioplasty. Results:The patients in the PEEK group had significantly higher hospitalization cost but significantly shortened length of hospital stay as compared with those in the titanium mesh group ( P<0.05). The overall incidence of complications in PEEK group was significantly lower than that in titanium mesh group ( P<0.05); the incidence of subcutaneous effusion in PEEK group was significantly lower than that in titanium mesh group ( P<0.05). The PEEK group had significantly higher proportion of patients with good satisfaction in postoperative plasticity, and significantly higher proportions of patients having increased GOS and MMSE scores as compared with the titanium mesh group ( P<0.05). Multivariate Logistic regression analysis showed that repair material was an independent factor for postoperative complications of cranioplasty ( OR=4.550, P=0.019, 95%CI: 1.281-16.161). Conclusion:As compared with titanium mesh, PEEK costs more, but its clinical application effect is better, especially in reducing postoperative complications; selection of appropriate repair materials can be used as one of the methods to reduce postoperative complications.