内镜下减压植骨融合内固定术联合阶段性腰背肌功能锻炼对退行性腰椎管狭窄症患者腰椎功能恢复的影响

Effect of Endoscopic Decompression Implant Fusion Internal Fixation Combined with Staged Lumbar Back Muscle Functional Exercise on Lumbar Functional Recovery in Patients with Degenerative Lumbar Spinal Stenosis

目的观察内镜下减压植骨融合内固定术联合阶段性腰背肌功能锻炼对退行性腰椎管狭窄症(DLSS)患者腰椎功能恢复的影响.方法选取2019年7月—2022年7月本院收治的80例DLSS患者,按红蓝球法分组,观察组与对照组各40例.两组均行内镜下减压植骨融合内固定术,对照组术后进行常规康复训练,观察组术后进行阶段性腰背肌功能锻炼.对比两组患者的康复情况.结果术后3个月,观察组的疼痛视觉模拟评分、Oswestry功能障碍指数评分分别为(1.74±0.63)分、(21.01±2.55)分,均低于对照组,日本骨科协会腰痛评价量表评分为(24.68±2.43)分,高于对照组,组间差异有统计学意义(P<0.05).术后3个月,观察组的全血高切粘度、血浆黏度、全血低切粘度水平均低于对照组,组间差异有统计学意义(P<0.05).观察组的并发症发生率为5.00%,低于对照组的20.00%,差异有统计学意义(P<0.05).结论内镜下减压植骨融合内固定术联合阶段性腰背肌功能锻炼能促进DLSS患者的腰椎功能恢复,有效加快血液循环,降低并发症发生率,值得临床推广使用.

Objective To observe the effect of endoscopic decompression implant fusion internal fixation combined with staged lumbar back muscle functional exercise on lumbar function recovery in patients with degenerative lumbar spinal stenosis(DLSS).Methods A total of 80 DLSS patients admitted to the hospital from July 2019 to July 2022 were selected and grouped according to the red and blue ball method,with 40 cases in the observation group and 40 cases in the control group.Both groups underwent endoscopic decompression implant fusion internal fixation.The control group underwent routine rehabilitation training after surgery,and the observation group underwent staged lumbar back muscle functional exercise after surgery.The recovery of the two groups of patients was compared.Results 3 months after surgery,the pain visual analog scale score and the Oswestry disability index score of the observation group were(1.74±0.63)points and(21.01±2.55)points,respectively,both of which were lower than those of the control group,the Japanese Orthopaedic Association score of the observation group was(24.68±2.43)points,higher than that of the control group,and the differences between the groups were statistically significant(P<0.05).3 months after surgery,the levels of whole blood high shear viscosity,plasma viscosity and whole blood low shear viscosity in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 5.00%,lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Endoscopic decompression implant fusion internal fixation combined with staged lumbar back muscle functional exercise can promote the recovery of lumbar function in DLSS patients,effectively accelerate blood circulation,reduce the incidence of complications,and is worthy of clinical application.