| Objective To evaluate the efficacy and safety of posterolateral Fusion(PLF)in the treatment of lumbar spinal stenosis associated with type 2 diabetes.Methods According to the case cohort study,88 patients who met the study criteria were divided into observation group and control group.All the patients were patients with lumbar spinal stenosis combined with type 2 diabetes mellitus.The control group received conservative treatment methods,including dehydration,pain relief,nutritional nerves,physical therapy,etc.The treatment cycle was 2 weeks;the observation group received lumbar PLF surgery.Observation curative effect,including the treatment before the Visual Analogue Scale(Visual Analogue Scale,VAS)and lumbar Oswestry Disability scores(Oswestry Disability Index,ODI),treatment after 1 week,2 weeks,4 weeks,8 weeks,12 weeks ODI score,VAS score and lumbar spine treatment glycated Hemoglobin(Hb A1c)Hemoglobin A1 c,before and after treatment 1 week,4 weeks,8 weeks,12 weeks of Hb A1 c,bed time during treatment,the recurrence rate in 12 weeks,The incidence of lower limb thrombosis,walking distance 12 weeks later,aerobic exercise time 12 weeks later,etc.To analyze the differences in efficacy indicators and evaluate the efficacy of PLF in the treatment of patients with lumbar spinal stenosis combined with type 2 diabetes mellitus.Blood parameters(including liver and kidney function,ions,homocysteine,etc.)before and after treatment were observed to evaluate the safety of treatment.Results In this study,a total of 88 cases were enrolled in the study,including 44 cases in the observation group and 44 cases in the control group.During the study period,9 cases were detached,2 cases in the observation group and 7 cases in the control group.Finally,79 cases were completed,including 42 cases in the observation group and 37 cases in the control group.Before treatment,independent sample t test was conducted on the baseline data of the two groups of cases,and the results showed P > 0.05,showing no statistically significant difference and comparability.Efficacy indicators: the results of VAS score analysis before and after treatment showed that VAS score in the group was significantly different with the extension of time,P < 0.05,and the comparison between the two groups was also different,P < 0.05,and the interaction between the group and the group was also significant,P < 0.05,and the VAS score in the observation group was significantly decreased compared with that in the control group.The results of ODI score were P < 0.05 for intra-group comparison,P < 0.05 for inter-group comparison,and P < 0.05 for intragroup and inter-group interaction.The observation group was significantly improved compared with the control group.The results of Hb A1 c analysis showed that P < 0.05 between the groups,P < 0.05 within the group,and P < 0.05 between the groups.The observation group was significantly improved compared with the control group,and the trend of postoperative blood glucose in the observation group was slightly increased and then decreased,which was considered as the effect of stress.Independent sample t test was conducted for VAS score,ODI score and Hb A1 c improvement rate,P < 0.05,indicating that the observation group was better than the control group.The observation group was larger than the control group,P < 0.05.The recurrence rate,incidence of thrombosis,travel distance after 12 weeks and aerobic exercise time after 12 weeks were all better in the observation group than in the control group.Analysis of the risk factors for thrombosis showed that preoperative LDL,Hb A1 c and bed time during treatment were the risk factors for thrombosis,while surgery was not the risk factor.Safety indicators,APTT,FIB,Kbefore and after treatment in the comparison of P < 0.05,statistically significant differences,but within the range of normal values,P > 0.05 between groups,statistically no differences,the remaining items between groups and before and after treatment all P > 0.05,statistically no differences.Conclusion For patients with lumbar spinal stenosis complicated with type 2 diabetes who meet the indications of surgery,surgical treatment has more advantages in improving symptom indicators than conservative treatment.Surgical treatment is better than conservative treatment in controlling blood glucose after treatment.There was no significant difference in safety between the two treatments.Figure 7;Table 12;Reference 130... |
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