A Comparative Study Of The Clinical Efficacy Of Different Surgical Methods In The Treatment Of Lumbar Spinal Stenosis

Objectives:In this study,we retrospectively analyzed the clinical efficacy of percutaneous endoscopic decompression(PED)and modified posterior lumbar interbody fusion(MPLIF)in the treatment of lateral recess stenosis of lumbar spinal stenosis.Methods: From June 2017 to June 2018,50 patients in orthopaedic ward of Sichuan Hospital of Traditional Chinese Medicine,25 in PED group,were treated with local anesthesia,lateral approach,13 males,12 females,18 L4/5 segments,7 L5/S1 segments,age range 45-80 years;25 in MPLIF group,20 L4/5 segments,5 L5/S1 segments,general anesthesia,11 males and 14 females,age range 45-80 years.All the above patients were single-level decompression.Visual analogue scale(VAS),ODI(Oswestry disability index),C-arm fluoroscopy times,operation time,hospitalization days and complications were recorded before operation,1 week,3 months and 6 months after operation.All patients were followed up 6 months after operation according to the scoring criteria of lumbago and backache surgery in the spine group of the Chinese Orthopedic Association.Functional score was used to evaluate the degree of surgical excellence,and the excellence rate of the two groups was compared comprehensively.Results:Intra-group analysis: VAS and ODI scores 1 week,3 months and 6 months after operation were significantly lower than those before operation,with significant difference(P < 0.05).Inter-group analysis: There was no significant difference in the scores of VAS and ODI between the two groups at 1 week,3 months,6 months after operation(P > 0.05);hospitalization days: PED group 4.75 + 0.49 days,MPLIF group 14.92 + 0.78 days,with significant difference between the two groups(P < 0.05);C-arm fluoroscopy times: PED group 14.12 + 1.97 times,MPLIF group 9.12 + 2.07 times,with significant difference(P < 0.05);operation time of the two groups: PED group 50.92 + 0.78 days(P < 0.05);There were 3 complications in the two groups,2 in the PED group and 1 in the MPLIF group.The excellent and good rate of operation was 88.00% in the PED group and 92.00% in the MPLIF group.There was no significant difference in the excellent and good rate between the two groups(P > 0.05).Conclusions:The above two surgical methods can achieve good therapeutic effect in improving the observation indexes such as lumbago and leg pain and improving the function of patients.The symptoms of the two groups tend to be stable after 3 months of treatment,and there is no significant difference in the statistical analysis of each index after 3 months and 6 months of operation.PED group had shorter operation time,fewer hospitalization days and more fluoroscopy times than MPLIF group;MPLIF had shorter operation time and longer hospitalization time than PED group.Therefore,the above observation results may not be the basis of the main choice of the two surgical methods,which should be determined by the surgeon's relevant surgical experience,combined with the patient's own symptoms and signs and the surgeon's own experience.