Clinical Analysis Of Interlaminar Decompression And Laminectomy In The Treatment Of Lumbar Disc Herniation Complicated With Cauda Equina Syndrome

Objective: :Objective to investigate the clinical efficacy of interlaminar fenestration decompression and laminectomy,decompression and fusion and internal fixation for the treatment of lumbar disc herniation complicated with cauda equina syndrome.Methods: Methods the clinical data of 40 patients with lumbar disc herniation complicated with cauda equina syndrome were analyzed retrospectively.Patients with lumbar disc herniation complicated with cauda equina syndrome were divided into two groups: laminectomy decompression(group A,20 cases),laminectomy,decompression,fusion and internal fixation(group B,20 cases).Comparative analysis and evaluation of clinical results: the operation time,bleeding volume,operation time;nerve function evaluation: lumbar JOA score(29 points),according to Nakano N standard of curative effect evaluation of curative effect after follow-up of 40 patients;imaging evaluation:postoperative lumbar x-ray(internal fixation device(stable condition B group),sagittal intervertebral displacement and intervertebral angle to improve the situation,the improvement of Cobb angle)Results: The difference of operation time and intraoperative blood loss between A and B groups was statistically significant(P < 0.05).There was no significant difference in the length of stay between the two groups of A and B(P > 0.05).The postoperative JOA scores of A and B groups were significantly different from those before operation(P< 0.05).Two groups of patients with curative effect evaluation results were as follows:excellent in 11 cases,good in 22 cases,5 cases,poor in 2 cases.During the follow-up period of group B internal fixation device without obvious loose,fracture,anchor and so on,in the B group with lumbar instability were: sagittal displacement and lumbar intervertebral angle has improved compared with the preoperative,the difference was statistically significant(P < 0.05),lumbar Cobb angle to improve the situation of B group was better than A group.The difference was statistically significant(P < 0.05)Conclusion: Two kinds of surgical treatment has good curative effect for the treatment of lumbar disc herniation with cauda equina syndrome,if patients have severe lumbar instability,spinal stenosis,spondylolisthesis or structural dynamic,more suitable for the selection of laminectomy decompression fusion and internal fixation.