Résumé
【Objective】 To investigate the clinical effects of treatment of single-segment lumbar tuberculosis by oblique lateral interbody fusion with autologous iliac bone and percutaneous pedicle screw fixation. 【Methods】 We collected the clinical data of 47 patients with lumbar tuberculosis treated in The First Affiliated Hospital of Xi’an Jiaotong University from March 2017 to January 2020. Among them， 22 patients underwent oblique lateral interbody fusion with autologous iliac bone and percutaneous pedicle screw fixation （minimally invasive group） and 25 patients underwent open surgery combined anterior-debridement and posterior-fixation （control group）. The related data were collected， including gender， sex， body mass index （BMI）， systemic symptoms of tuberculosis， operation duration， intraoperative bleeding， postoperative drainage， hospital stay， complications， visual analogue score （VAS）， erythrocyte sedimentation rate （ESR）， and Oswestry disability index （ODI）. 【Results】 Baseline clinical characteristics did not significantly differ between the two groups （P>0.05）. Compared with control group， the minimally invasive group had shorter operation duration ［（188.64±18.59） min vs. （201.60±22.67） min］， less intraoperative blood loss ［（118.64±22.95） mL vs. （553.60±100.54） mL］， less postoperative drainage ［（134.55±36.48） mL vs. （291.20±61.53） mL］， and shorter hospitalization time ［（12.86±2.17） d vs. （15.80±3.03） d］ （all P0.05）. Compared with the preoperative ones， ESR， VAS score and ODI score significantly decreased and Cobb angle significantly increased in both groups （all P0.05）. 【Conclusion】 Both minimally invasive technique and open surgery can achieve excellent clinical results， but the minimally invasive technique can reduce the surgical trauma and shorten the hospitalization time.
Résumé
Objective To investigate clinical effect of limited decompression under endoscope combined with percutaneous transpedicular screw fixation for treatment of degenerative lumbar spinal stenosis.Methods Thirty-four senile patients with lower lumbar spinal stenosis were selected as our subjects from February 2010 to August 2011,and were treated with limited decompression under endoscope combined with percutaneous transpedicular screw fixation through posterior approach.The VAS scores of all patients were collected at the four periods including pre-operation,leaving hospital,3 months after operation,and the last follow-up.The therapeutic effectiveness for the postoperative follow-up was expressed as excellent,good,ordinary,and poor according to Nakai standard.Results The VAS scores at pre-operation,leaving hospital,3 month after operation,and the last follow-up were (7.9 ± 1.6),(2.9 ± 1.4),(1.9 ± 1.9),(2.4 ± 1.5)respectively,and the difference was significant (F =13.524,P =0.036).But no significant differences of VAS scores at three sequential tests after operation were observed (P ＞ 0.05).In the last postoperative follow-up,32 cases were graded as excellent,1 cases for good and 1 case for ordinary,and the excellent rate reached to 97％.Conclusion The therapeutic effectiveness of lumbar spinal stenosis limited decompression under endoscope combined with percutaneous transpedicular screw fixation is reliable.Furthermore,no side effects on spine and back muscles are observed.