| Objective:Limited Compare lumbar spinal decompression surgery since the differences between the particles bone interbody fusion with interbody fusion cage interbody fusion of the two surgical methods of treatment effect, choose a suitable secondary treatment of elderly patients with lumbar disc lumbar spinal stenosissurgical treatment of patients with effective and rational economic basis..Methods:group of20Retrospective analysis from January2010to December2011Xinjiang Medical University First Clinical Medical College two years, admitted to48cases diagnosed as lumbar disc herniation secondary to lumbar spinal stenosis patients underwent the limited posterior lumbar canal decompression combined with vertebralpedicle screw fixation and interbody fusion surgery, hospitalization and post-discharge follow-up medical records complete segment L4-L5disc herniation and spinal stenosis in27cases, L5S1in segment disc and spinal stenosis in22cases, L3-L4sectiondisc herniation and spinal stenosis in9cases,38cases of single-segment, the double segment10cases, aged60to76years, with an average of67.96years old,8to24months of follow-up, an average of14months, based on the fusion of the way different grouping A group for impaction grafting autologous bone particles intervertebral group B for interbody fusion group, A patients, aged60to76years, with an average of68.35years of age,11were male and9females,28cases of group B, bone, age61to75years, an average of67.68years,15males and13females. Observed postoperative ambulation time, before and after surgery and follow-up to the end of the nowadays the waist and lower extremity pain score (JOA), disability index (ODI), to calculate the rate of improvement after circumference surgical complication rate and hospitalization during treatment costs and other indicators, the use of statistical methods compare treatment differences.Results:The average time of the postoperative postoperative ambulation were (6.85±2.134) d (5.96±1.527) d, the average postoperative JOA score (14.00±3.28) and (14.61±3.29), ODI Index postoperativescores were (27.05%±12.8%)(28.89%±963%), group A, the last follow-up, excellent12Li, good in6cases,2cases,90%of poor patients, excellent rate; group B last follow-up, excellentl8cases, good in7cases, and poor in one cases, excellent rate of89.28%; the average total cost of hospitalization of the two groups, respectively (39525.95±1280.44) and$(65928.00±13770.6), group3cases of cerebrospinal fluid leakage after extended bed resttime, incision oppression, intermittent occlusion of the drainage tube symptomatic treatment measures healed in5-9days; B group and five cases of cerebrospinal fluid leakage occurred in the yellow ligament and epidural adhesions and decompression process hardspina injury, symptomatic treatment in5-7days healed after surgery interbody fusion shift one cases,1months the Yao Tuiteng symptoms again attack symptoms admission surgery to adjust the position of the interbody fusion. Postoperative Yao Tuiteng symptoms improved significantly, not as wound infection and other complications.Conclusion:Two surgical methods for the treatment of elderly patients with lumbar disc herniation secondary to lumbar stenosis is safe and effective, the intervertebral autologous bone particles suppress bone fusion effect is remarkable, since the particles bone interbody financial technique is reliable, fewer complications,one of the low medical costs, there is no statistically significant difference in treatment effect interbody fusion group, especially advantage merger vertebral osteoporosis patients, can be used as elderly patients with lumbar degenerative preferred treatment method... |
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