| Objective To explore the clinical effect of nerve root block combined with percutaneous transforaminal endoscopic technique in the treatment of lumbar disc herniation in the elderly.Methods A total of 65 patients with degenerative lumbar disc herniation aged over 65 years were randomly selected from the department of orthopedics of State Gird Beijing Electric Power Hospital from January 2017 to December 2021. All patients had complex multi-segmental herniation on imaging. There were 28 males and 37 females, aged between 65 and 88 years, with a mean age of 68.8 years. After 6 months of conservative treatment, all patients were admitted to the hospital. After admission, nerve root block was used to determine the single responsible segment, and then percutaneous transforaminal endoscopic surgery was used to remove the protruding nucleus pulposus tissue. The Japanese Orthopedic Association (JOA) score, Oswestry disability index (ODI), waist and leg visual analogue scale (VAS) were used to evaluate the clinical effect, and imaging was used to observe the activity of the surgical segments. A series of changes include range of motion (ROM), overall lumbar spine mobility, and adjacent segment degeneration.Results All patients were followed up for 9 to 35 months. All patients underwent a nerve root block to confirm the responsible segment, and the operation time was 75-120 min, with an average of 98.5 min. The clinical symptoms of all patients improved to varying degrees after surgery, and there were no obvious complications. Compared with preoperative and final follow-up, there was no significant change in the surgical segment mobility and overall lumbar spine mobility in patients with lumbar disc herniation, and the difference was not statistically significant (P>0.05). The JOA score, ODI index, waist VAS score, and leg VAS score at the last follow-up were all significantly improved compared with those before surgery, and the difference was statistically significant (P<0.05).Conclusion Nerve root block can effectively determine the responsible segment for complex multi-segment lumbar disc herniation in the elderly. Intervertebral foraminal discectomy is effective in treating lumbar disc herniation in the elderly with less paravertebral muscle damage, good bone structure preservation, and rapid recovery, low surgical risk and other characteristics. |
