经椎旁肌间隙入路行腰椎后路椎管减压融合治疗腰椎管狭窄症的疗效及预后评价

The Efficacy and Prognosis of Lumbar Spinal Stenosis Treated by Posterior Lumbar Spinal Fusion with Paraspinal Muscle Approach

目的讨论经椎旁肌间隙入路行腰椎后路椎管减压融合治疗腰椎管狭窄症的疗效及预后评价。方法在2016年11月—2017年11月选取该院中出现腰椎管狭窄的患者120例,根据随机数字法分为两组,其中实验组中使用经椎旁肌间隙入路实行腰椎后路的椎管减压融合的方法,在对照组中使用传统的后正中入路实行腰椎后路椎管减压融合方法。结果实验组使用的手术时间(153.8±34.16)min小于对照组(195.4±38.56)min,差异有统计学意义(P<0.05)。实验组的住院天数(11.66±1.35)d小于对照组(15.71±0.76)d,差异有统计学意义(P<0.05)。实验组手术中的出血量(265.1±14.27)m L小于对照组(423.15±30.05)min,差异有统计学意义(P<0.05)。实验组的不良反应(46.67%)小于对照组(13.33%),差异有统计学意义(P<0.05)。结论对腰椎管狭窄的患者使用颈椎旁肌间隙入路实行腰椎后路的椎管减压融合的方法,可以减少手术后并发症的发生,减少手术中出血量,具有重要的临床价值。

Objective This paper tries to discuss the efficacy and prognosis of lumbar spinal stenosis treated by posteri- or lumbar spinal fusion with paraspinal muscle approach. Methods From November 2016 to November 2017, 120 pa- tients with lumbar spinal stenosis in this hospital were selected and divided into two groups according to the random number method. The paravertebral muscle approach was used in the experimental group to perform lumbar posterior ap- proach. In the spinal fusion decompression method, the posterior lumbar spine decompression fusion method was per- formed using a conventional posterior median approach in the control group. Results The operative time of the experi- mental group was （153.8±34.16）rain less than that of the control group （195.4±38.56）rain. The difference was statistical- ly significant （P〈0.05）. The length of stay in the experimental group （11.66±1.35）d was lower than that of the control group （15.71±0.76）d, and the difference was statistically significant （P〈0.05）. The amount of blood loss in the experi- mental group （265.1±14.27）mL was lower than that in the control group （423.15±30.05）mL, and the difference was sta- tistically significant （P〈0.05）. The adverse reaction （46.67%） in the experimental group was smaller than that in the control group （13.33%）, and the difference was statistically significant （P〈0.05） Conclusion The method of lumbar spinal canal decompression and fusion using lumbar spinal stenosis in patients with lumbar spinal stenosis can reduce postoperative complications and reduce the amount of blood loss during surgery. It has important clinical value.