Curative Effect Observation Of Based On Magnetic Resonance Neurography Microscope-assisted Microsurgery Treatment On Multi-segments Lumbar Degeneration Disease

Objective:To evaluate the microscope-assisted microsurgery treatment on multi segments lumbar degeneration disease positing the liability segment based on the magnetic resonance neurography technology of the short-term clinical effect.And to explore the advantages and disadvantages of the operation method and the related matters needing attention,and the value of promoting in clinical treatment to provide reference for the future. Methods:Select the 36 patients being diagnosed as multi-segments lumbar degeneration disease admitted by Wuhan Union Orthopaedics Hospital Spine Surgery from 2012.9 to 2015.7 whose primarily complaints were lumbocrural pain and lower limb numbness. Positing the liability segment causing the symptom and physical sign based on the magnetic resonance neurography technology. Comprehensive evaluating the age, general physical condition, spinal degeneration, therapeutic aim, financial situation,then give treatment of microscope-assisted microsurgery decompression and discectomy on the liability segment.Compared the JOA,ODI and VAS socres at 1 day before operation and 14 days after operation and 6?12 months or longer follow-up results after surgery to judge the Curative effect. Results:All patients were followed-up 12 months at least to 42 months. 36 patients whose JOA?ODI and VAS scores in 14 days after operation compared with 1 day before operation were improved significantly(p<0.05).All patients expressed certainty to the effect of this treatment in 12 months postoperation follow-up. 21 cases(58.33%)got excellent in JOA score,12 cases(33.33%) got good,3 cases(8.33%) got improved;32 patients? ODI score(91.67%) was the exllent or good;VAS scores decrease from average 7.1 preoperation to 1.7 postoperation;In lastest follow-up 2 patients had neurologic disorders of the opposite side or the other side symptoms were aggravated,but conservative treatment s were still effective.Till now there was no recurrence in the operative levels in all patients. Conclusion:In the procedure of diagnose and treat the multi-segments lumbar degeneration disease, positing the liability segment causing the symptom and physical sign based on the magnetic resonance neurography technology,treatment of microscope-assisted microsurgery decompression and discectomy on the liability segment could achieve the aim of satisfactory short-term clinical effect. The scope of surgery could be limited because of definite liability segment and minimal invasive operation,the incidence rate of complications could be decreased,most bone and soft tissue would be reserved so that the patients did not have to strictly confined to bed for a long time.and it was free of spinal internal fixation.So this minimally invasive surgery is safe and reliable with the advantages of satisfactory clinical effect, minimal injury, less complications, less total cost,quicker recoverory etc,which is worthy of promotion in clinic if the hardware conditions could meeted.