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TITLE:

RESULTS WITH TRANSFORMATIONAL ENDOSCOPY COMPARED TO PERCUTANEOUS ENDOSCOPY LASER DECOMPRESSION FOR CONFINED LUMBAR DISC HERNIATION

AUTHORS:

Dr Qamar Abrar, Muhammad Irsalan Khalid, Dr Muazzma Manzoor

ABSTRACT:

Aim: Contained lumbar plate herniation habitually cause back-and leg torment. Clinical results with careful treatment might be influenced by the size and area of the plate herniation. The careful straightforwardly pictured transformational endoscopic decompression has picked up acknowledgment and fame, while the rearranged percutaneous laser plate decompression has become undesirable regardless of its underlying accomplishment as a negligibly obtrusive intercession. While trying to all the more likely comprehend the solidness of the two strategies, the creators played out a near investigation of clinical results in patients with contained lumbar circle herniation. Methods: The study population consisted of 267 patients, including 169 endoscopy patients (group 1) and 88 laser patients (group 2). Key outcome measures were ManabĂ­ standards. Hernias were classified as either huge or small. Our current research was conducted at Mayo Hospital, Lahore from May 2019 to April 2020. The additional limits of degeneration of the lumbar movement section, including the back plate and the <5 mm parallel rupture heel plate, were recorded. IBM SPSS 28.0 was used for the Kaplan-Meier endurance test and cross-organization of these factors with measurable tests for huge affiliations. Results: The average length of the subsequent period was 44.7 months. The sequential time recorded for the Kaplan-Meier examination ranged from 1.6 to 88 months. The mean age was 54.38 years (SD = 14.65 years). Most patients achieved excellent and good Macnab results (213/249; 87.6%) with little attention to treatment. Reasonable and poor results were obtained in an additional 36 patients (15.6%). Excellent Macnab results were higher in the endoscopic group (96/164; 59.1%) than in the laser group (38/86; 45.3%) at a huge measurable level (P<0.0002). There was an essentially measurably higher level of Excellent and Good Macnab results with endoscopic decompression of a small paracentral hernia (98.2%; P<0.0002). Percutaneous laser percutaneous decompression of a huge focal circle hernia was measurably no better than careful endoscopic decompression (P=0.126). Endoscopic decompression of hard and delicate tissue was also better than laser to mitigate side effects in patients with decreased back plate and parallel fracture size, with 97.8% of patients with a circle size decreased by <3 mm and 94% of patients with a parallel fracture size decreased by <4 mm (P=0.002). The Kaplan-Meier (K-M) survival time demonstrated a longer mean endurance of treatment benefit for patients who underwent imaginary conservative endoscopic decompression (68.2 months), in contrast to the median K-M endurance time for percutaneous laser decompression of 18 months (P<0.0002). Conclusion: Transformational endoscopic decompression for the indicative hernia circle is a powerful and robust treatment that reduces sciatic and dorsal manifestations in most patients, with high long-term endurance and up to six years of discomfort relief. Interventional percutaneous laser non-imaging percutaneous decompression for a similar condition can provide positive results in the present moment with delicate projections. Nevertheless, the impact of the treatment weakens much faster with an average endurance of 17 months. Keywords: transformational endoscopy, percutaneous endoscopy laser decompression, lumbar disc herniation.

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