| Objective:Comparison biomechanics effect of Axial compression,three-point bending,stretching of normal goat lumbar vertebrae,goat lumbar vertebrae after full laminectomy,goat lumbar vertebrae after multi-segment lamellar window stealth expansion.To explore the effect of Multi-segment lamellar window stealth expansion on lumbar stability,biomechanics is consequently provided in Surgical approach to support it.Methods : Select 30 adult goat lumbar vertebrae specimens,who are 2 to 2.5 years old,half male and half female.Exclude lumbar tumors,infections,deformities and other pathological conditions after examination.Remove muscle and soft tissue,and retain the vertebral body,intervertebral disc,ligament,joint capsule and other structures.First,30 goat lumbar vertebrae specimens(both L2 and L5 vertebrae)were embedded by a fixed mixture of dentifrice and resin,and fixed with an outer mold of 4 cm * 4 cm * 4 cm so that the two ends of each specimen were buried about 1/2 of its vertebral body,and try to ensure that the upper plane and the lower plane maintain parallel.Thirty specimens were randomly divided into 3groups.Each group was modeled in different ways: group A was the normal group and no special treatment was needed.Group B was the full laminectomy group.The full laminectomy did Lamina bite to 10 specimens with 2.5mm Lamina clamp,and to joint facet joint for 1/3 or so.Two slices of the full laminectomy were performed on each specimen.Group C was the window group,using 2.5mm laminectomy to perform multi-segment window treatment on 10 specimens,with 4 windows on each specimen and about 1 window on each section.The window size was 2cm * 1cm with stealth expansion of 0.5cm.The mechanical tests were carried out by a biomechanics testing machine(BTS).The main items tested were three-point bending,stretching and axial compression.SPSS 19.0 statistical software was used for analysis and processing.All the data were tested by homogeneity of variance and normality.The data were expressed by x ±S,and using variance analysis to make comparison between groups.The significance of statistical test was ? = 0.05.Result:In the three-point bending mechanics test,the results of the three groups in the average maximum load,fixed load,upper yield strength,and lower yield strength were:Group A> Group C> Group B,the upper yield strength,and lower yield strength were:GroupB> Group C> Group A,with the differences of three groups compared,statistically significant(P <0.05);In the axial compression test,the results of the three groups in the maximum load,elastic modulus,constant load-displacement,breaking point load and other indicators were:Group A > Group C > Group B,with the differences of three groups compared,statistically significant(P <0.05);In the tensile mechanics test,there was no statistically significant in tensile mechanics in differences of the three groups(P> 0.05).Conclusion : Multi-segment lamellar window stealth expansion can provide a more stable mechanical environment on the condition of the axial compression,three-point bending and stretching,and provide a scientific biomechanics basis for the clinical use of this surgical approach.Objective : To explore the clinical effect of multi-segment lamellar window stealth expansion combined with the use of injury capsules during perioperative period.Method:Selected 50 cases of DLSS patients of January 2015 ~ December 2016 in the third spine orthopedic of Gansu Provincial Hospital of TCM in strict accordance with the inclusion criteria,exclusion criteria,cases.The fifty patients were divided into simple surgery group and surgery combined with traditional Chinese medicine group according to the principle of randomization.Two groups of patients were subjected to routine preoperative examination before multi-segment lamellar window stealth expansion surgery.In the simple surgery group,routine anti-infection,nutritional nerve and other symptomatic supportive therapy were given before and after operation;In the surgery combined with traditional Chinese medicine group on the basis of conventional treatment were given "injury capsules" made by Gansu Provincial Hospital of TCM.Taking time was 3 days after surgery,twice a day,4 to 6 tablets at a time,taking by warm water.The clinical outcomes of the two groups were evaluated by JOA score,ODI index and VAS pain score.The data were analyzed by SPSS19.0 software.The data were expressed by `x±S,and the compare between two groups were tested by independent sample t.The significance of statistical test was ? = 0.05.Result:JOA score: 2 weeks after surgery,the JOA score of simple surgery group was19.60 ± 2.61;2 weeks after surgery,the JOA score of surgery combined with traditional Chinese medicine group was 19.76 ± 2.96 points.The difference between the two groups was no statistically significant(P >0.05).4 weeks after surgery,the JOA score of simple surgery group was 22.64±1.63;One month after surgery,the JOA score of surgery combined with traditional Chinese medicine group was 23.20±1.66 points.The difference between the two groups was statistically significant(P <0.05).VAS score: 2 weeks and one 4 weeks after surgery,the VAS score of simple surgery group were 6.20±0.91 and4.64±0.70 respectively;2weeks and 4 weeks after surgery,the VAS score of surgery combined with traditional Chinese medicine group were 4.64±0.64 and3.76±0.72 respectively.The VAS scores of the two groups were statistically significant(P <0.05).ODI index: 2 weeks after surgery,the ODI index of simple surgery group was 40.72±8.54%;4 weeks after surgery,the ODI index was38.00±7.53%;2 weeks after surgery,the ODI index of surgery combined with traditional Chinese medicine group were 34.16±4.67%;4 weeks after surgery,the ODI index was25.52±3.75%.The ODI index of the two groups was statistically significant and the difference was statistically significant(P <0.05).Conclusion:Combining with the use of injury capsules during perioperative period can help improve patients' quality of life after multi-segment lamellar window stealth expansion.It can not only effectively contact the patients' nerve root symptoms caused by nerve compression,but also benefit patients with perioperative recovery and functional exercise. |
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