| Objective:To compare total laminectomy and pedicle screw fixation with microscopic and ultrasound-assisted laminectomy in the treatment of lumbar spinal canal tumors,so as to provide a new surgical option for the treatment of lumbar spinal canal tumors.Materials and methods:A retrospective study was conducted to select 62 patients with lumbar spinal canal tumors who met the inclusion criteria from September 2016 to January 2018 in the Sino-Japanese Friendship Hospital of Jilin University.They were divided into A and B groups according to different surgical methods.They were divided into A and B groups according to different surgical methods.Group A underwent total laminectomy and pedicle screw internal fixation in 32 patients,18 males and 14 females,with an average age of 32.67 ± 7.57,a course of 11.30 ± 3.08 months,a preoperative JOA score of 14.63±2.47 and a preoperative VAS score of 7.43±0.72;Group B underwent microsurgery and ultrasound-assisted laminectomy.There were 30 patients,17 males and 13 females,with an average age of 36.67 ±7.32 years,a course of 11.47±2.75 months,a preoperative JOA score of 14.17±2.01 and a preoperative VAS score of 7.37±1.11.There were no significant differences in gender,age,course of disease,preoperative JOA score of lumbar spine and preoperative VAS pain score between the two groups(P > 0.05).The operation time,intraoperative bleeding volume,operative segment,hospitalization time,bedridden time,JOA score and VAS pain score of lumbar spine were recorded at 1 week,3 months and 6 months after operation.SPSS software 20.0 was used for statistical analysis.T test was used for the data and chi-square test was used for the measurement data.The results showed that there were differences between the two groups(P < 0.05).Results:All patients completed the operation successfully,and the follow-up rate of both groups was 100%.There are two ways of follow-up,one is to fill in the visual analogue VAS pain score form and lumbar JOA score form on the spot,the other is to fill in the small program APP software evaluation by means of Wechat.The operation time was 125.47 ±24.51 minutes in group A and 126.23 ± 17.43 minutes in group B;Hospitalization time: 9.96±1.18 days in group A and 8.83±0.89 days in group B;Postoperative bed rest time: A group 6.94±1.26 days,B group 6.11±0.79 days;intraoperative bleeding volume: A group 348.73 ±176.49 ml,B group 192.16±45.31ml;Postoperative drainage: group A 462.81±396.36,group B 93.92±38.11.Surgical segments: 22 cases two segments and 10 cases in three segments in group A;21 cases two segments and 9 cases in three segments in group B.VAS pain score 1 week,3 months and 6 months after operation,group A: 5.27±0.85/4.40±1.05/2.83±0.86,group B: 5.30±0.86/2.40±0.88/1.80±0.80.JOA score of lumbar spine in 1 week,3 months and 6 months after operation,group A: 15.47 ± 2.55/17.93 ± 1.67/20.07 ± 1.29,group B: 15.54 ±1.16/20.17±1.19/23.90±1.58.According to JOA score improvement of Japan Plastic Association,group A: excellent 5 cases,good 15 cases,medium 12 cases,poor 0 cases,the excellent and good rate was 62.50%;group B: excellent 6 cases,good 20 cases,medium 4 cases,poor 0 cases,the excellent and good rate was 86.67%.According to the amount of bleeding during operation,length of hospital stay and bed rest time,drainage after operation,and follow-up results of 3 months and 6 months after operation,the operation of laminectomy and spinal internal fixation assisted by microscope and ultrasound scalpel is superior to that total laminectomy and pedicle screw fixation.Conclusion:1.Microscopic and ultrasound-assisted laminectomy has the advantages of less intraoperative bleeding and postoperative drainage,shorter hospital stay and bed rest.2.Microscopic and ultrasound-assisted laminectomy for lumbar spinal canal tumors is superior to total laminectomy and pedicle screw internal fixation.It is a good choice for the treatment of lumbar spinal canal tumors and is worthy of clinical promotion. |
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