Study On Application Of Nerve Root Sedimentation Sign In The Diagnosis And Treatment Of The Lumbar Spinal Stenosis

Purpose:Observing the differences between the anticipating results of non-surgical and surgical treatment of nerve root sedimentation sign for lumbar spinal stenosis (LSS), and making analysis on its possible factors; observing the distributional differences of nerve root sedimentation sign in terms of Traditional Chinese Medicine (TCM) Syndrome, gender and age group.Methodology:(1) Making retrospective study about the magnetic resonance imaging (MRI) of 60 inpatient cases, dividing them into negative nerve root sedimentation sign and positive one which respectively consists of two groups, namely, non-surgical treatment group and surgical treatment group. Firstly, making comparison of the overall JOA score and Oswestry Disability Index (ODI) difference between negative group and positive group; secondly, separately comparing the JOA score and ODI difference between non-surgical treatment and surgical treatment in both negative and positive groups; thirdly, comparing the JOA score and ODI difference of non-surgical treatment between negative group and positive one; and finally comparing the JOA score and ODI difference of surgical treatment between negative group and positive one. (2) dividing 60 out-patient cases or inpatient cases into negative nerve root sedimentation sign and positive one which are sub-grouped into three types, that is, wind-cold obstruction pattern, kidney deficiency syndrome, and qi deficiency and blood stasi. Then, observing the distributional differences of nerve root sedimentation sign in terms of TCM Syndrome, gender and age group.Results:(1) Based on the overall comparison between negative nerve root sedimentation and positive one, the JOA score before the treatment and after one-year treatment do not embrace any discrepancy (P>0.05), while the JOA score improvement difference is statistically significant (P<0.01); ODI before treatment has discrepancy (P<0.05), while ODI as well as ODI improvement difference do not possess any discrepancy (P>0.05). (2) Through the comparison between the non-surgical and surgical treatment in negative group of nerve root sedimentation sign, JOA score before treatment do not have any discrepancy (P>0.05), but after one year treatment, the JOA score and its improvement difference are endowed with discrepancy (P<0.05). Besides, before treatment, the ODI embraces no discrepancy (P>0.05) while after one year treatment, it embraces obvious discrepancy (P<0.01) as well as the ODI improvement difference (P<0.05). (3) When comes to the positive nerve root sedimentation sign group, the comparison between non-surgical treatment and surgical treatment shows that the JOA score before treatment does not have any discrepancy (P>0.05), the JOA score and its improvement difference after one year treatment have discrepancy (P<0.05), and ODI difference before treatment embraces no discrepancy (P>0.05) while ODI and its improvement difference have discrepancy (P<0.05). (4) Among the TCM syndrome distribution, there are 8 cases of negative wind-cold obstruction pattern and 11 cases of positive one,13 cases of negative qi deficiency and blood stasi and 11 cases of positive one, and 9 cases of negative kidney deficiency syndrome and 8 cases of positive one. It turns out that the overall distributional difference of each syndrome in both negative and positive nerve root sedimentation groups do not have any discrepancy (P<0.05). (5) In terms of difference age group,12 cases of negative nerve root sedimentation sign are between the age of 40 to 49, while positive one amounts to 11 cases; 6 negative cases are between the age of 50 to 59 while there are 12 positive cases; and among the age ranking from 60 to 70 years old, there are 12 negative cases and 7 positive ones. There is no apparent discrepancy of distribution of negative and positive nerve root sedimentation sign in terms of age group (P>0.05).Conclusions:(1) The overall condition of the negative and positive nerve root sedimentation sign is improved, while the negative one is superior to the positive one. (2) The effect of non-surgical treatment in negative nerve root sedimentation sign is better than surgical treatment. As for patients with negative nerve root sedimentation sign, great caution should be put while surgical treatment is been chosen and symptoms of lumbar part and lower extremity resulting from other diseases shall be avoided with great efforts. (3) As for positive nerve root sedimentation sign, surgical treatment is obviously better than non-surgical treatment whose effects are limited for patients with positive nerve root sedimentation sign. (4) No apparent difference could be found between difference gender as well as age group. Similarly, no apparent difference could be found among wind-cold obstruction pattern, qi deficiency and blood satsi and kidney deficiency syndrome as well as difference age groups.