The Clinical Observation Of The Surgical Treatment Of The Elderly Multileval Lumbar Spinal Stenosis And The Effect Of Acupuncture On Postoperative Abdominal Distension

Objective:This study is conducted to compare the early effects of the elderly multileval lumbar spinal stenosis by posterior laminectomy decompression, intervertebral graft, and pedicle screw fixation surgery, and the effect of acupuncture Zusanli acupoint on postoperative abdominal distension.Methods:From June 2009 to September 2010,43 elderly patients with multileval lumbar spinal stenosis accepted surgical treatments in our hospital of spinal suregery department were included in a prospective describation clinical study., including 15 males and 27 females, aged 60-81 years old, average 71.6 years old; the courses of disease were from 4 months to 20 years, the average of 3.6 years; All patients were accepted posterior laminectomy decompression, intervertebral graft, and pedicle screw fixation. All patients before surgery, the first 3 months,6 months,and final follow up were assessed clinically with Oswestry disability index(ODI),Visual analog scale(VAS), and JOA score. Lumbar anterior-posterior and lateral X-radiongraphs, extend and flexion X-radiongraphs were obtained by every follow-up, and to evaluate the outcomes of fusion, fixation failure, pseudoarticulation formation, and adjacent segments degeneration. Observer the effects of acupuncture Zusanli acupoint on postopervative abdominal distension.Result:43 cases were followed up for 6 months to 15 months (mean 9.4 month). There is a significant difference in ODI, VAS, and JOA after surgery third month, sixth month, and last follow-up, compare with preoperative. The final follow up compared with preoperative JOA score, improvement rate was 71.62%, good rate of 86.04%; fusion rate was 100%, complication rate was 6.98%. The effect of acupuncture Zusanli acupoint on postoperative abdominal distension was 93.55%.Conclusion:1. It is safe and effective to treat the elderly multileval lumbar spinal stenosis by posterior lamina resection decompression, intervertebral graft, and pedicle screw fixation through short-term follow-up observation, and significant improved neurofunction and lumbar pain.2. The intervention of acupuncture Zusanli acupoint can improve the effect of postopervative gastrointestinal functional recovery for the elderly multilevel lumbar spinal stenosis, which is convenient, swift, and nonpoisonous, suitable for popularizing.