| Objective:microscope assisted laminectomy has become the most commonly used surgical method for the treatment of lumbar spinal stenosis(LSS).With the continuous development of spinal endoscope technology,delta large channel endoscope technology(ilessys delta)has also achieved good curative effect in the treatment of LSS.The purpose of this study was to evaluate the clinical efficacy of delta large channel technique and microscope assisted laminectomy in the treatment of LSS.Methods:from May 2018 to June 2020,149 patients with LSS diagnosed and treated in our hospital were collected and divided into two groups:80 patients in delta channel technology group(FE Group)and 69 patients in microscope assisted laminectomy group {Micro group).The average follow-up time was 13.3±4.3 months.Visual analogue scale(VAS)was used to quantify the pain degree of lower back(VAS-LBP)and lower limb(VAS-LP)before operation,1 month,3 months,6 months and 12 months after operation.The numbness degree of lower limb was evaluated by 11 point digital score scale(NRS-LN),and the quality of life was evaluated by modified Oswestry disability index(ODI);At the last follow-up,the modified macnab standard was used to evaluate the treatment effect.All patients had single segment lumbar spinal stenosis.The perioperative data such as the length of hospital stay,the time to go down,the operation time and the amount of intraoperative bleeding,the imaging data such as X-ray,CT and MRI of lumbar spine before and at the last follow-up,and the postoperative complications were counted respectively.Results:111 patients(62 in Fe Group and 49 in micro group)completed the follow-up,and the follow-up rate was 74.50%.In the general data of patients,there no significant difference in baseline characteristics such as age,gender,BMI index,surgical segment,degree of stenosis and medical diseases between the two groups(P>0.05).The scores of VAS-LBP,VAS-LP,NRS-LN and modified ODI in the two groups were significantly improved compared with those before operation(P<0.05).Except that one week after operation,the vas-lbp in the Fe Group was lower than that in the micro group(2.24±1.25 vs 3.17±1.50,P<0.05).There was no difference among the score groups at other follow-up time points(P>0.05).In terms of clinical data,the length of stay in Fe Group was 4.00(3.00,5.00)days vs 7.5 days 00(6.00,8.00)days,(P<0.05);Intraoperative bleeding was 17.50(14.00,25.00)ml vs 125.00(110.00130.00)ml(P<0.05);And underground time 2.00(1.50,4.00)days vs5 00(4.00,7.00)days,(P<0.05),which were smaller than those in the microstructure;On the contrary,the operation time was 92.50(84.75,97.00)min vs 75.00(69.00,78.00)min(P<0.05).In terms of surgical satisfaction,the excellent and good rates of Fe Group and microscope group were 83.87%and 85.71%respectively(P>0.05),and there was no significant difference in postoperative complications between the two groups(P>0.05).Conclusions:Both microscope-assisted laminar fenestration and Delta large-channel techniques provide equivalent and satisfactory treatment results,while Delta large-channel technique has several potential advantages for the treatment of LSS,including faster recovery and earlier lower VAS-LBP.However,further follow-up and studies are needed for long-term ontcomes. |
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