经后路开窗减压矫形融合内固定术治疗DLSS合并LS患者的临床疗效

doi:10.3969/j.issn.1006-6233.2022.10.09

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Abstract Objective: To investigate the clinical efficacy of posterior fenestration, decompression, orthopedic fusion and internal fixation (PLIF) in the treatment of DLSS combined with LS. Methods: 109 patients with DLSS and LS were randomly divided into observation group (n=55) and control group (n=54). The control group was treated with total laminectomy (LAM) and intervertebral fusion IF, and the observation group was treated with PLIF. The effects of different surgical methods on lumbar stability, sagittal spine morphology lumbar dysfunction were compared. And complications were recorded. Results: There was a significant difference between the two groups in terms of vertebral fusion one year after operation (P<0.05). The intraoperative blood loss in the observation group was significantly lower than that in the control group, the operation, bed rest and hospitalization time were lower than that in the control group, and the incision length was shorter than that in the control group (P<0.05). After surgery, lumbar lordosis angle (LL), shapeless vertical axis (SVA), pelvic incidence (PI), thoracic kyphosis angle (TK) and pelvic tilt angle (PT) in both groups were significantly decreased, but there was no significant difference between the two groups in the above indexes before and after operation (P>0.05). After operation, the spinal dysfunction score (ODI) and pain score (VAS) of the two groups were significantly decreased, and the human dysfunction score (JOA), intervertebral space height, intervertebral foramen height, and lumbar lordosis angle were increased. The difference of the above indexes before and after operation between the two groups was statistically significant (P<0.05) Conclusion: In the clinical treatment of patients with DLSS and LS, PLIF and LAM interbody fusion IF have the same effect in spinal canal fusion and spinal morphology improvement, but the former has less trauma, low pain and less blood loss, and can effectively promote the recovery of limb function, which is worthy of clinical promotion.

Key words： Posterior fenestration decompression Internal fixation Degenerative lumbar spinal stenosis Segmental lumbar instability

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.10.09 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I10/1631

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