| Objective: Through the posterior fenestration,decompression and reduction of iliac bone grafting and internal fixation for the treatment of lumbar spondylolisthesis,and the combined use of the hospital's in-hospital preparation "Injury Capsule"(Chinese medicine combined surgery group)The efficacy of the "Injury Capsule"(surgical group)in the treatment of lumbar spondylolisthesis was compared to study the clinical efficacy of the combined operation of the capsule in the treatment of lumbar spondylolisthesis,and provide a new idea for the treatment of the disease.Methods: Sixty patients with lumbar spondylolisthesis admitted to the Department of Spinal Bone in Gansu Provincial Hospital of Traditional Chinese Medicine were selected.Sixty patients with lumbar spondylolisthesis were divided into the operation group and the operation combined with traditional Chinese medicine group according to the computer-generated random number table 1:1.Each group had 30 cases.Both groups underwent posterior fenestration and decompression and reduction of iliac bone graft.Internal fixation.Patients underwent preoperative and postoperative lumbar spine X-ray,lumbar MRI and/or lumbar vertebra CT.The HIS system was used to analyze and measure the software.The slip rate was measured before,after and 12 months.The height of the intervertebral space,the height of the intervertebral foramen,and the angle of slippage were measured.The anteroposterior diameter of the spinal canal was measured before and after the operation.The bone graft fusion rate was recorded at the last follow-up,and the changes of the indexes were observed.The patients in the operation group were given postoperatively.In the conventional symptomatic treatment,the patients in the traditional Chinese medicine combined operation group were given "Injury Capsule" on the 3rd day under the premise of routine symptomatic treatment in the operation group,orally,8 capsules a day,2 times a day,one month for one course of treatment.Functional recovery and pain were compared between the two groups before treatment,2 weeks after treatment,1 month after treatment and 3 months after treatment using JOA score and VAS score.Results:(1)The preoperative spondylolisthesis rate and preoperative detachment angle were significantly lower than those after operation.The height of preoperative intervertebralspace and the height of preoperative intervertebral foramen were significantly higher than those after operation(P<0.05).There was no significant difference in the rate of spondylolisthesis,postoperative intervertebral space height,postoperative intervertebral foramen height and postoperative spondylolisthesis compared with 12 months after operation(P>0.05).There was a significant increase in the half year,and the difference was statistically significant(P<0.05).From the imaging point of view,this procedure is effective in the treatment of lumbar spondylolisthesis.(2)According to the comparison of JOA scores,after treatment with posterior fenestration and decompression and reduction of iliac bone grafting and internal fixation,the two groups of patients recovered significantly compared with preoperative function,which was statistically significant(P<0.05);the comparison between the JOA group at 2 weeks after treatment,1 month after treatment and 3 months after treatment was statistically significant(P<0.05).The value of the combined Chinese medicine was higher than that of the operation group.(3)Calculate the improvement rate of JOA score before and 3 months after treatment.The average improvement rate of 66.66% in the operation group is lower than the improvement rate of 83.16% in the combined Chinese medicine group.The average improvement rate of the operation group after the operation is reached.The "good" standard,while the surgery combined with the Chinese medicine group reached the "excellent" standard,the "excellent" standard of the operation combined with the Chinese medicine group was significantly higher than the surgical group.(4)By comparing the results of VAS scores,after treatment with posterior fenestration and decompression and reduction of iliac bone grafting and internal fixation,the two groups of patients were significantly more painful than preoperative pain,statistically significant(P<0.05).The comparison between the VAS group at 2 weeks after treatment,1 month after treatment and 3 months after treatment was statistically significant(P<0.05).The value of the combined Chinese medicine was higher than that of the operation group.Conclusion:(1)Posterior fenestration and decompression and reduction of iliac bone grafting and internal fixation can reduce the vertebral body of the LS patients,and the height of the intervertebral space and the height of the intervertebral foramen are increased todifferent degrees,and the angle of slippage is reduced.The anteroposterior diameter of the spinal canal is increased to restore the physiological curvature of the spine;the maximum possible preservation of the spine process complex integrity,the stability of the spine,the loss of postoperative spondylolisthesis,the loss of postoperative intervertebral space,and the loss of postoperative intervertebral foramen height The probability of loss of slip angle after surgery is reduced,the bone grafting surface is large,and the bone graft fusion rate is high,which can better relieve pain and improve lumbar function.(2)Injury Capsule can improve the residual lumbar and leg pain and dysfunction in patients with LS after posterior fenestration and decompression and reduction of iliac bone graft and internal fixation.The short-term effect is significant.(3)Posterior fenestration decompression and reduction of iliac bone grafting internal fixation and postoperative application of Injury Capsule are effective for the treatment of LS,and it is a safe and reliable treatment plan with better clinical application value. |
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