| Objective:To analyze and compare the clinical effects of the application of PELD in the treatment of ruptured posterior longitudinal ligament and non-rupture LDH.Methods:To collect and sort out the data of patieents with LDH treated by PELD combined with TCM in Jiangsu Provincial Hospital of auricular pressure bean and fumigation with traditional Chinese medicine from January 2016 to December 2017.Based on magnetic resonance imaging data,LDH was divided into two groups:non-rupture longitudinal ligament group and ruptured posterior longitudinal ligament group.According to the Visual Analogue Score(VAS),Oswestry Disability Index(ODI)and the modified MacNab standard,the clinical efficacy of the two groups was compared before surgery and 3 days,1 month,3 months,6 months and 1 year after surgery.The average age of the two groups was 47.26±13.17 and 45.28±12.80.In terms of sex ratio,the proportion of men and women in the non-rupture group was 22:21,and that in the rupture group was 40:14.The averaige hospitalization time of the non-rupture group was 5.00±1.75 days,and that of the ruptured group was 5.561±2.00 days.The mean operation time of the non-rupture group was 105.58±36.22,while that of the non-rupture group was 107.97±35.85.The mean VAS score of the non-rupture group was 2.81±0.45 3 days after surgery,and the mean VAS score of'the ruptured group was 2.26±0.68.The mean VAS scores of the non-rupture group were 1.53±0.86,1.09±0.65,and those of the ruptured group were 1.22±0.60,0.78±0.82,respectively,1 month and 3 months after the operation.The mean VAS scores of the non-rupture group before surgery,6 months and 1 year after surgery were 6.6310.85,0.3310.72 and 0.1910.50,respectively.The mean values of VAS in the fracture group were 6.98±0.94,0.3010.74 and 0.20±0.59.The mean ODI of the non-rupture group before surgery was 68.23±8.80,and that of the ruptured group was 70.50±10.20.One month after operation,the mean ODI of the no n-rupture group was 25.1 6 ±16.1 2,and that of the ruptured group was 19.41±9.32.The mean ODI of the non-rupture group was 14.00±7.52 and that of the ruptured group was 18.04±11.43 at 3 months after surgery.At 6 months and 1 year after surgery,the ODI mean of the non-rupture group was 5.63±6.1 1,1.53±4.14,and that of the ruptured group was 6.33±7.97,1.85±5.71.In the improved MacNab score of the non-rupture group 1 year after surgery,there were 36 excellent cases and 5 good cases,accounting for 95.34%.In the improved MacNab score of the rupture group 1 year after surgery,there were 46 excellent cases and 5 good cases,accounting for 94.44%.Results:There was no statistical difference in sex,age,operation time and hospitalization time between the non-rupture group and the ruptaure group(P>0.05).There were significant statistical differences in VAS scores of 3 days,1 month and 3 months after operation(P<0.05).There was no statistical difference in VAS scores of preoperative,6 months and 1 year after operation between the two groups(P>0.05).There was statistical difference in ODI scores of 1 month and 3 months after operation between the two groups(P<0.05).There was no difference in ODI scores of preoperative,6 months and 1 year after operation(P>0.05).The excellent and good rate of the improved MacNab score was more than 90%in both groups one year after operation.Conclusion:Patients with LDH with non-rupture posterior longitudinal ligament or ruptured posterior longitudinal ligament have obvious clinical effects a fter PELD combined with traditional Chinese medicine treatment. |
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