减压融合内固定术治疗伴Ⅰ度退行性滑脱的腰椎管狭窄症的疗效分析

Analysis on curative effect of decompression and fusion internal fixation in the treatment of lumbar spinal stenosis accompanied by Ⅰ degree degenerative spondylolisthesis

目的探讨减压融合内固定术治疗伴Ⅰ度退行性滑脱的腰椎管狭窄症的疗效。方法回顾性分析2015年3月~2017年12月我院收治的伴Ⅰ度退行性滑脱的腰椎管狭窄症患者170例,根据其手术方案分为观察组94例和对照组76例。对照组行单纯减压治疗,观察组行减压融合内固定术治疗。分析两组患者手术情况、术前后JOA评分、VAS评分及腰椎滑脱程度。结果观察组手术时间长于对照组,且术中出血量多于对照组,同时术后不良反应高于对照组,差异有统计学意义(P <0.05);两组患者术后JOA评分较术前升高,差异有统计学意义(P <0.05);术后两组患者腰腿痛VAS评分及腰椎滑脱程度均较对照组降低,且观察组患者降低幅度大于对照组,差异有统计学意义(P <0.05)。结论伴Ⅰ度退行性滑脱的腰椎管狭窄症应用减压融合内固定术能有效改善患者腰椎功能、减轻腰腿疼痛程度。

Objective To explore the curative effect of decompression and fusion internal fixation in the treatment of lumbar spinal stenosis accompanied by Ⅰ degree degenerative spondylolisthesis. Methods 170 patients with lumbar spinal stenosis accompanied by Ⅰ degree degenerative spondylolisthesis who were admitted and treated in our hospital from March 2015 to December 2017 were retrospectively analyzed.According to the operation scheme,they were divided into the observation group with 94 cases and the control group with 76 cases.The control group was treated with simple decompression while the observation group was treated with decompression and fusion internal fixation.The operation condition,preoperative and postoperative JOA score,VAS score and lumbar spondylolisthesis degree of the two groups were analyzed. Results The operation time of the observation group was longer than that of the control group,the amount of bleeding during operation was more than that of the control group and the adverse reactions after operation were higher than that of the control group.The differences were statistically significant(P < 0.05).JOA score after operation of the two groups was higher than that before operation,and the difference was statistically significant(P < 0.05).After operation,the VAS score of pain in waist and lower extremities and lumbar spondylolisthesis degree in two groups were decreased.The degree of reduction in the observation group was greater than that in the control group,and the difference was statistically significant(P < 0.05). Conclusion Decompression and fusion internal fixation in the treatment of lumbar spinal stenosis accompanied by I degree degenerative spondylolisthesis can effectively improve the lumbar function of patients and reduce the pain degree of lumbar and leg.