| Objective: To explore the application of percutaneous transforaminal microscopy and Delta large channel technique in the surgical treatment of lumbar spinal stenosis.Methods: Lumbar collected in our hospital from September 2015 to September 2017 were 150 cases of tube stenosis,were single segment lumbar stenosis,underwent conventional posterior decompression of the spinal canal decompression and interbody fusion and internal fixation in 100 cases as control group,L4/5 segment symptomatic side percutaneous transforaminal endoscopic decompression in 40 cases and Delta channel decompression in 10 cases of minimally invasive surgery for the experimental group.The average course of disease was 3.2 years,and the average follow-up time was 6.2 months.Respectively before and after surgery in 1 days,3 months and at the last follow-up lumbar and leg pain visual analogue score(visual analogue,scale,VAS)to assess the pain grade,Oswestry disability index(Oswestry disability,index,ODI)assessment of quality of life and improved Mac Nab curative effect evaluation standard to analyze and evaluate the clinical curative effect of.Preoperative and final follow-up X-ray,CT and MRI imaging data were analyzed the clinical data and operative time,intraoperative bleeding volume and hospitalization time.Results: compared with the control group to reduce postoperative lumbocrural pain rate was 100% in the experimental group,there is no significant difference(P > 0.05),the experimental group average was(55.36+-3.53)years old,the average operation time(1.43+-0.16)h,the average amount of bleeding during operation(20.84 + 3.26)ml,the average time in bed(10.13+-2.54)h,the average hospitalization time(3.16 + 1.25)d,the average hospitalization cost of(13536.36 +-1082.29)yuan,with an average follow-up time of(10.71 + 1.89)months;control group,the average age was(63.27 + 3.52)years,the average operation time(1.82 +-0.21)h,the average amount of bleeding during operation(220.84+-31.31)ml,average the bed time is(72.70+-6.23)h,the average hospitalization time(5.51+-1.52)d,the average hospitalization cost of(35890.50 +1544.78)yuan,with an average follow-up time of(10.71+-1.89)months,the experimental group was significantly less than the control group,P < 0.05 difference with statistical significance.In the experimental group treated with percutaneous transforaminal endoscopic simple lumbar disc herniation and spinal canal stenosis in 40 cases,spinal canal stenosis and intervertebral foramen stenosis in 25 cases,vertebral facet hypertrophy,hyperplasia or hypertrophy of ligamentum flavum of spinal canal stenosis in 15 cases,3months after surgery,5 patients appeared again and again aggravating waist the revision,are facet hypertrophy or vertebral bone hyperplasia caused by spinal stenosis type,Delta channel technology treating group patients without lumbocrural pain exacerbation and revision,significantly,P < 0.05 with statistically significant difference.Conclusion: In the treatment of lumbar spinal stenosis by percutaneous transforaminal endoscopic technique and Delta channel technology in the near future is a satisfactory clinical effect,compared with the traditional technique in single segmental lumbar stenosis,unilateral nerve symptoms,relatively limited stenosis treatment with small trauma,quick recovery,accurate decompression and other advantages of percutaneous transforaminal endoscopic discectomy the technology of simple lumbar disc herniation and spinal stenosis or lumbar intervertebral foramen stenosis stenosis,better treatment effect,Delta channel technology of facet joint bone hyperplasia or hypertrophy of ligamentum flavum lumbar spinal canal stenosis caused by better curative effect,long-term efficacy on Delta channel effect is better than that of percutaneous transforaminal endoscopic discectomy and traditional open therefore,the two techniques in the treatment of lumbar spinal stenosis has its own advantages,the advantages of using two complementary advantages,but the long-term results need further research. |
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