The optimization scheme of posterior percutaneous endoscopic interlaminar decompression for degenerative lumbar spinal stenosis / 中国基层医药

ABSTRACT

Objective To observe the surgical results of modified percutaneous endoscopic interlaminar decompression(PEID) and traditional PEID in the treatment of degenerative lumbar spinal stenosis (DLSS),and to explore the optimizations scheme of PEID for DLSS.Methods 60 patients (36 males and 24 females) were brought into the research for DLSS.According to the different operation ways,the patients were randomly divided into the modified PEID group(observation group) and traditional PEID group (control group) according to the digital table method,30 cases in each group.The surgical outcome,indicators included the change in spinal canal,visual analogue scale (VAS) score and Oswestry disability index (ODI) at pre-operation,postoperative 3 d,postoperative 3 months and postoperative 6 months,operation time,headache and painful stiff nape incidence in the operation,postoperative complications were compared between the two groups.Results The VAS scores (postoperative 3 days,postoperative 3 months and postoperative 6 months) of the observation group were (4.37 ± 1.20) points,(2.59 ± 1.30) points,(1.29 ± 1.21)points respectively,which of the control group were (4.45 ± 1.22)points,(2.67 ± 1.36)points,(1.17 ± 1.10)points respectively,which were significantly better than (7.93 ± 1.56)points of the observation group and (8.22 ± 1.70) points of the control group before operation,the differences were statistically significant (F =1 254.387,512.762,all P ＜ 0.05).The ODI scores (postoperative 3 days,postoperative 3 months and postoperative 6 months) of the observation group were (48.64 ± 19.59) points,(27.66 ± 10.22) points,(10.69 ± 8.87) points respectively,which of the control group were (47.22 ± 20.96) points,(25.17 ± 11.93) points,(10.16 ± 7.89) points respectively,which were significantly better than (75.20 ± 23.20) points of the observation group and (70.35 ± 28.66) points of the control group before operation,the differences were statistically significant(F =1 254.387,512.762,all P ＜ 0.05).The VAS and ODI scores (pre-operation,postoperative 3 days,postoperative 3 months andpostoperative 6 months) of the observation group and control group had no statistically significant differences (VASt =2.088,2.124,3.021,3.173;ODIt =2.366,1.079,1.694,1.573,all P ＞ 0.05).The incidence of neck pain and operation time of the observation group were 20.69％,(63 ± 7) min,which were significantly lower than 87.50％ and (157 ± 8)rin of the control group,the differences were statistically significant(t =3.601,2.167,all P ＜ 0.05).The central sagittal diameter of the spinal canal and the central transverse diameter of the spinal canal between the observation group and the control group had no statistically significant differences (x2 =4.260,t =3.694,all P ＞ 0.05).Conclusion Modified PEID has advantages in surgical efficiency,operation time and headache and painful stiff nape incidence compared with traditional PEID,so it can be chosen for DLSS.