全可视内镜下腰椎融合术与传统后路融合术治疗单节段腰椎管狭窄症的临床疗效比较OA

Objective To compare clinical efficacy of endoscopic lumbar interbody fusion(Endo-PLIF)and traditional posterior lumbar interbody fusion(PLIF)in treating single-segment lumbar spinal stenosis.Methods From July 2021 to April 2022,56 patients with lumbar spinal stenosis who underwent lumbar decompression and fusion were included,and divided into observation group and control group according to treatment methods.There were 29 patients in observation group,including 16 males and 13 females;aged from 41 to 65 years old with an average of(53.64±6.34)years;body mass index(BMI)ranged from 10 to 35 kg·m-2 with an average of(23.38±2.92)kg·m-2;2 patients with L3,4,15 patients with L4,5,and 12 patients with L5S1;treated with Endo-PLIF.There were 27 patients in control group,including 15 males and 12 females;aged from 42 to 60 years old with an average of(55.41±5.82)years;BMI ranged from 12 to 28 kg·m-2 with an average of(24.20±2.18)kg·m-2;1 patient with L3,4,17 patients with L4,5,and 9 patients with L5S1;treated with PLIF.Operation time,incision length,intraopera-tive blood loss,postoperative drainage volume,hospital stay,and occurrence of postoperative complications between two groups were compared.Visual analogue scale(VAS)for lower back and lower limb pain and Oswestry Disability index(ODI)at pre-operative,3 days postoperative,3 months postoperative,and the latest follow-up postoperative were assessed.Results Both groups of patients were followed up,the follow-up period for observation group ranged from 4 to 8 months with an average of(7.3±2.2)months,and for control group ranged from 6 to 10 months with an average of(8.1±1.7)months;there was no statis-tically significant difference between two groups(P＞0.05).Operation time,incision length,intraoperative blood loss,postoper-ative drainage volume and hospital stay of observation group were(140.24±45.39)min,(3.10±0.70)cm,(125.36±25.59)mL,(50.36±15.59)mL and(11.00±2.36)days respectively,while those of control group were(132.56±48.26)min,(10.10±1.00)cm,(258.51±38.25)mL,(155.28±21.34)mL and(18.00±2.58)days respectively;and the differences were statistically significant compared between two groups(P＜0.05).VAS and ODI scores of lumbar and leg regions at 3 days,3 months,and the final follow-up after operation were all improved compared with those of preoperative,and the differences were statistically significant(P＜0.05).Moreover,VAS and ODI scores of lumbar and leg regions at each time point after operation in observation group were better than those in control group(P＜0.05).At the latest follow-up,there were no cases of screw fracture,loosen-ing,or fusion device withdrawal were found.No nerve root injuries occurred in either group after surgery.In observation group,1 patient experienced increased leg pain and 1 patient experienced increased leg numbness;1 patient had cerebrospinal fluid leakage,2 patients had increased leg pain,1 patient had leg numbness,and 2 patients had incision necrosis in control group;the number of complications in observation group was better than that in control group,and had siginificant difference(P＜0.05).Conclusion Compared with PLIF,Endo-PLIF has satisfactory therapeutic effects.It has advantages of reducing surgical trauma,shortening hospital stay of patients,and effectively improving symptoms.