Efficacy Of Two Surgical Procedures For The Treatment Of Lumbar Spinal Stenosis With Bilateral Nerve Symptoms

Objective To compare the curative effect of the posterior lumbar interbody fusion(PLIF)and transforaminal lumbar interbody fusion(TLIF)combined with fenestration decompression on the other side for the treatment of lumbar spinal canal stenosis with bilateral nerve symptoms.Method To collect the data of patients with lumbar spinal stenosis and surgical treated from February 2014 to March 2015,according to the inclusion criteria,to choose the patients with bilateral nerve symptoms were treated with single segment(L4/5,L5/S1)decompression fixation and fusion.Among them,32 cases underwent PLIF operation,TLIF combined with contralateral fenestration decompression group(hereinafter referred to as TLIF+ fenestration group)32 cases,record the general condition,hospitalization time,operation time,intraoperative blood loss,postoperative drainage complication rate andinterbody fusion rate of each patient,all the patients were assessed the visual analogue scale(VAS)and Oswestry disability index(ODI)when before operation,after discharge,3 months,6 months and 12 months after operation,and keep the preoperative and postoperative imaging data.Results All patients were followed up for 25 to 38 months,average of 27.2 months.Two groups of patients with gender differences,because the choice of sample size is too small.There was no significant difference in age(P>0.05),TLIF+ fenestration group hospitalization time was less than the PLIF group,the difference was statistically significant(P<0.05),the operation time,Intrao-perative blood loss and postoperative drainage of TLIF+ fenestration group was less than the PLIF group,the difference was statistically significant(P<0.05),There was no significant difference in ODI score and VAS score between the two groups before,during and after the treatment(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Two groups of patients with postoperative interbody fusion rate was 100%.Conclusion Both PLIF and TLIF+ fenestration operation are effective methods for the treatment of lumbar spinal stenosis with bilateral neurologic symptoms,the hospitalization time,operation time,intraoperative blood loss and postoperative drainage of TLIF+ fenestration operation were less than PLIF operation.TLIF+ fenestration group is a safe and effective surgical method with shorter operation time,less blood loss and quicker recovery.The reasonable choice of surgical methods should be based on the indications.