| Objective:To compare the efficacy of unilateral approach to bilateral decompression and Posterior lumbar Interbody fusion in the treatment of lumbar spinal stenosis with a unilateral approach to preserve the posterior ligament complex Methods:A retrospective analysis was performed from 60 patients with absolute lumbar spinal stenosis admitted to the Second Affiliated Hospital of Nanchang University and its affiliated hospitals from November 2020 to June 2022,30 patients in group A had unilateral approach bilateral decompression surgery,and 30 patients in group B had traditional total laminectomy,and the perioperative related indexes of patients with two treatment modes were collected,including: operation time,intraoperative blood loss,time to remove drainage tubes,length of hospital stay,number of complications,VAS and JOA scores,etc.,1 month after surgery,At 3 months and 6months of outpatient follow-up,the imaging data and JOEA and VAS scores were reviewed to compare and analyze group A and group B,so as to obtain the clinical efficacy analysis of the two surgical methods.Outcome:The modified surgery group had significant advantages over the total laminectomy group in terms of operation time,length of hospital stay,intraoperative blood loss and postoperative drainage flow,and the difference was statistically significant(P<0.05).The transverse diameter of the spinal canal and the sagittal diameter of the lateral crypt were significantly increased between the two groups compared with the preoperative period,and the difference was not statistically significant(P>0.05).The postoperative clinical efficacy scores of JOA,VAS,ODI and so on in the two groups were significantly improved compared with the preoperative period.There was no significant difference in the scores in the 1-month follow-up cycle after surgery(P>0.05),and the JOA,VAS,ODI and other score improvement surgery groups were improved compared with the traditional surgery group during the 3 months and 6 months follow-up cycle after surgery,and the difference was statistically significant(P<0.05).Compared with the total laminectomy group,the fat infiltration degree of lumbar back muscles(mainly including multifissure,erector spine muscle and longest muscle)was significantly improved in the modified surgery group.Complications:1 case of postoperative infection occurred in group A and 2 cases of postoperative infection occurred in group B.Conclusion:Compared with total laminectomy,retaining the posterior ligament complex unilateral approach and bilateral decompression treatment of lumbar spinal stenosis not only has great advantages in operation time,bleeding and other data,but also the incidence of long-term complications such as low back pain is much smaller than that of traditional surgery. |
