Clinical Study Of Spinal Endoscopy In The Treatment Of Multi-segment Degenerative Lumbar Spinal Stenosis Based On Precision Medical Mode

Background: To explore the safety and effectiveness of spinal endoscopy in the treatment of multi-segment degenerative lumbar spinal stenosis based on precision medical mode.Methods: A retrospective analysis of a total of 64 patients with multi-segment degenerative lumbar spinal stenosis undergoing surgical treatment in the orthopedic inpatient ward of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from October2017 to October 2019 using a precision medical model to determine responsible segments.According to the surgical methods,they were divided into two groups: spinal endoscopy group was treated with percutaneous spinal decompression,and laminar decompression group was treated with traditional open laminar decompression.Visual analogue scale,Oswestry Disability Index,Japanese Orthopaedic Association Scores,Macnab curative effect assessment and lumbar-pelvic sagittal parameters were used to evaluate and compare their curative effects.The results were analyzed using SPSS 26.0 software.Results: The procedure was smooth in all patients.There was no significant difference in gender,age,BMI,duration of disease,duration of follow-up,responsible segments,diseased segments,stenotic segments,and distribution of symptoms between the two groups(P>0.05).In terms of surgical time,surgical incision length,and length of hospital stay,The spinal endoscopy group was significantly smaller than the laminardecompression group,and the differences were statistically significant(P<0.05);there was no statistically significant difference in the incidence of postoperative complications between the two groups of patients(P> 0.05).By comparing the VAS,ODI,and JOA scores of the two groups of patients at different time points(preoperative,1 day after surgery,1month after surgery,3 months after surgery,6 months after surgery,and last follow-up),it was found that the interaction between surgical methods and time The effects of the effects on waist and leg VAS score,ODI score,and JOA score were statistically significant(P <0.05);the waist and leg VAS score,ODI score,and JOA score of the two groups were significantly lower than those before surgery.All were statistically significant(P <0.05).Compared with the laminar decompression group,the leg VAS score,ODI score,and JOA score of the spinal endoscope group were statistically significant(P <0.05).The waist VAS score of the spinal endoscope group was significantly lower than that of the laminar decompression group at 1 day and 1 month after operation,the difference was statistically significant(P <0.05).The lumbar lordosis,sacral slope,pelvic tilt,and pelvic incidence were compared between the two groups of patients before and after the last follow-up.There was no significant difference(P> 0.05).In the laminar decompression group,the difference between pelvic incidence and pre-operation was not statistically significant,while the lumbar lordosis and pelvic tilt angles were larger than before,and the sacral slope was smaller than before,and the difference was statistically significant(P < 0.05).However,in the spinal endoscopy group,although there were changes in all indicators at the last follow-up,there was no statistically significant difference compared with before surgery(P> 0.05).The excellent rate was 93.75% in the spinalendoscopy group and 90.63% in the laminar decompression group.There was no significant difference in the incidence of postoperative complications between the two groups(P> 0.05).Conclusions: Using the precision medical model to determine the responsibility segment is the basic condition for reasonable choice of treatment plan,and it is also the main reference for precise decompression during surgery.The early efficacy of spinal endoscopy based on precision medical mode in the treatment of multi-segment degenerative lumbar spinal stenosis is equivalent to that of traditional laminar decompression surgery.Spinal endoscopy based on precision medical mode has the advantages of less surgical trauma,significant early efficacy,and faster postoperative recovery.It is an effective and minimally invasive technique for the treatment of multi-segment degenerative lumbar spinal stenosis.