Effect of spinal minimally invasive nucleus pulpectomy on the levels of serum TXB2, PGE2, IL-6 and lumbar spine function in patients with lumbar disc herniation

doi:10.3877/cma.j.issn.2096-0263.2020.05.006

Abstract

Abstract:

Objective

To investigate the effects of spinal minimally invasive nucleus pulpectomy on the levels of serumthromboxane B₂ (TXB₂), prostaglandin E₂ (PGE₂), interleukin-6 (IL-6) and lumbar spine function in patients with lumbar disc herniation.

Methods

Retrospective analysis of 80 patients with lumbar disc herniation admitted to the hospital between May 2017 and May 2019, according to the different surgical methods, they were divided into the laminectomy group and the perforating nucleus pulposynthesis group, with 40 cases in each group, the two groups were followed up for 3 months. The surgical related indicators between the two groups of patients were conmpared; the levels of serum TXB₂, PGE₂, IL-6, TNF-α and complications before and after 3 days of surgery were compared; The scores of VAS, ODI, and JOA in the two groups of patients before and 3 months after the operation were compared.

Results

Eighty patients were followed up for 3-6 months. The incision length (0.7±0.3) cm, the operation time (73±22) min, and the bed rest time (1.2±0.4) d in the perforated intervertebral nucleus pulposus removal group were shorter than the laminectomy nucleus pulposus removal group [(3.8±1.7) cm, (106±28) min, (1.2±0.4) d, t=11.230, 5.840, 8.771, P<0.05)], intraoperative blood loss (44±15) mL was less than the lamina nucleus pulposus enucleation group [(98±34) mL, P<0.05)]. Compared with before surgery, the levels of serum TXB₂, PGE₂, IL-6, and TNF-αin the two groups were significantly reduced after 3 days of surgery (P<0.05), and the perforating nucleus pulposynthesis group was lower than the laminectomy group (t=6.271; 4.925; 4.963; 24.947, P<0.05); Compared with before surgery, the scores of VAS and ODI in the two groups were significantly reduced after 3 months of surgery (P<0.05), and the perforating nucleus pulposynthesis group was lower than the laminectomy group (P<0.05); Compared with before surgery, the score of JOA in the two groups increased significantly after 3 months of surgery (P<0.05), and the perforating nucleus pulposynthesis group was higher than the laminectomy group (P<0.05); The total incidence of complications in the perforating nucleus pulposynthesis group 5.00%was significantly lower than that in the laminectomy group 25.00% (χ²=4.800, P<0.05).

Conclusion

Percutaneous foraminal nucleus enucleation as a spinal minimally invasive surgery can reduce the levels of serum TXB₂, PGE₂, and IL-6 in patients with lumbar disc herniation, alleviate back pain symptoms, and help patients with lumbar spine function recovery. It is worthwhile Promotion and application.

Key words: Lumbar disc herniation, Nucleus pulposus, thromboxane B₂, Prostaglandin E₂, Interleukin-6

Wei Zhang, Yongdong Wu, Yi Li, Xiaolong Tang. Effect of spinal minimally invasive nucleus pulpectomy on the levels of serum TXB2, PGE2, IL-6 and lumbar spine function in patients with lumbar disc herniation[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2020, 06(05): 279-284.

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References 23

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组别	例数	性别（例）		年龄（岁， ±s）	BMI（kg/cm²， ±s）	突出节段（例）
组别	例数	男性	女性	年龄（岁， ±s）	BMI（kg/cm²， ±s）	L_3/4节段	L_4/5节段
经皮椎间孔镜下髓核摘除术组	40	23	17	46±5	18±1	5	35
椎板开窗髓核摘除术组	40	25	15	47±5	19±2	4	36
统计值	?	χ²=0.512		t=0.894	t=0.451	χ²=0.443
P值	?	>0.05		>0.05	>0.05	>0.05

组别	例数	性别（例）		年龄（岁， ±s）	BMI（kg/cm²， ±s）	突出节段（例）
组别	例数	男性	女性	年龄（岁， ±s）	BMI（kg/cm²， ±s）	L_3/4节段	L_4/5节段
经皮椎间孔镜下髓核摘除术组	40	23	17	46±5	18±1	5	35
椎板开窗髓核摘除术组	40	25	15	47±5	19±2	4	36
统计值	?	χ²=0.512		t=0.894	t=0.451	χ²=0.443
P值	?	>0.05		>0.05	>0.05	>0.05

组别	例数	切口长度（cm）	手术时间（min）	卧床时间（d）	术中出血量（mL）
经皮椎间孔镜下髓核摘除术组	40	0.7±0.3	73±22	1.2±0.4	44±15
椎板开窗髓核摘除术组	40	3.8±1.7	106±28	2.2±0.6	98±34
t值	?	11.230	5.840	8.771	9.190
P值	?	<0.001	<0.001	<0.001	<0.001

组别	例数	切口长度（cm）	手术时间（min）	卧床时间（d）	术中出血量（mL）
经皮椎间孔镜下髓核摘除术组	40	0.7±0.3	73±22	1.2±0.4	44±15
椎板开窗髓核摘除术组	40	3.8±1.7	106±28	2.2±0.6	98±34
t值	?	11.230	5.840	8.771	9.190
P值	?	<0.001	<0.001	<0.001	<0.001

组别	例数	术前
组别	例数	TXB₂（ng/L）	PGE₂（pg/mL）	IL-6（μg/L）	TNF-α（g/L）
经皮椎间孔镜下髓核摘除术组	40	44±6	202±46	138±18	0.59±0.08
椎板开窗髓核摘除术组	40	44±6	207±46	140±17	0.57±0.09
t值	?	0.395	0.502	0.612	1.050
P值	?	0.694	0.617	0.543	0.217
组别	例数	术后3 d
组别	例数	TXB₂（ng/L）	PGE₂（pg/mL）	IL-6（μg/L）	TNF-α（g/L）
经皮椎间孔镜下髓核摘除术组	40	25±4^*	129±20^*	100±12^*	0.13±0.03^*
椎板开窗髓核摘除术组	40	31±5^*	153±24^*	115±14^*	0.36±0.05^*
t值	?	6.271	4.925	4.963	24.947
P值	?	<0.001	<0.001	<0.001	<0，001

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