电针联合聚醚醚酮棒半刚性固定治疗腰椎管狭窄症的疗效及安全性分析

Treatment outcome and safety of electroacupuncture combined with PEEK rod semi-rigid fixation in the treatment of lumbar spinal stenosis

目的分析电针联合聚醚醚酮(PEEK)棒半刚性固定治疗腰椎管狭窄症(DLSS)病人的疗效及安全性。方法选取2020年7月至2021年7月在保定市第二中心医院初诊DLSS病人90例,采用随机数字表法分为对照组45例,联合组45例。对照组给予PEEK棒半刚性固定治疗,联合组给予电针联合PEEK棒半刚性固定治疗。经8周治疗后,比较两组影像学指标[手术节段活动范围(ROM)、椎体前缘高度丢失率、Cobb角],血清学指标[皮质醇(COR)、乳酸脱氢酶(LDH)、肌红蛋白(MYO)],功能指标[Oswestry功能障碍指数(ODI)、日本骨科协会评估治疗分数(JOA评分)],疼痛程度[视觉模拟评分法(VAS)],评价两组临床疗效及安全性。结果治疗后,联合组和对照组ROM[(1.7±0.2)°、(2.1±0.3)°]、椎体前缘高度丢失率[(11.5±1.3)%、(15.8±1.6)%]、Cobb角[(11.3±1.3)°、(14.9±1.5)°]、ODI评分[(15.8±1.6)分、(20.4±2.1)分]、疼痛VAS评分[(1.74±0.21)分、(2.12±0.26)分]均低于治疗前[(4.4±0.5)°、(4.3±0.4)°;(32.8±3.3)%、(32.3±3.2)%;(23.7±2.4)°、(22.9±2.3)°;(62.1±6.4)分、(61.7±6.2)分;(5.40±0.57)分、(5.36±0.54)分,均P<0.05],且联合组低于对照组(P<0.05)。治疗后,联合组和对照组血清COR、MYO、LDH水平、JOA评分均高于治疗前(P<0.05),且联合组高于对照组(P<0.05)。联合组总有效率98%高于对照组82%(P<0.05)。随访12个月后,联合组并发症发生率4%低于对照组22%(P<0.05)。结论电针联合PEEK棒半刚性固定治疗DLSS疗效确切,能明显改善腰椎功能,减轻疼痛,且安全性高。

Objective To analyze the treatment outcome and safety of electroacupuncture combined with polyetheretherketone(PEEK)rod semi-rigid fixation for patients with degenerative lumbar spinal stenosis(DLSS).Methods A total of 90 newly diagnosed DLSS patients in Baoding No.2 Central Hospital from July 2020 to July 2021 were selected and assigned into control group(n=45)and combination group(n=45)by random number table method.The control group was given PEEK rod semi-rigid fixation,while the combination group was given electroacupuncture combined with PEEK rod semi-rigid fixation.After 8 weeks of treatment,the imaging indexes[range of motion of operative segment(ROM),loss rate of anterior vertebral body height,Cobb angle],serological indexes[cortisol(COR),lactate dehydrogenase(LDH),myoglobin(MYO)],functional indexes[Oswestry Disability Index(ODI),the Japanese Orthopaedic Association score(JOA score)],pain level[visual analogue scale(VAS)]of the two groups were compared,and clinical efficacy and safety of the two groups were evaluated.Results After treatment,the ROM[(1.7±0.2)°,(2.1±0.3)°],loss rate of anterior vertebral body height[(11.5±1.3)%,(15.8±1.6)%],Cobb angle[(11.3±1.3)°,(14.9±1.5)°],ODI score[(15.8±1.6)points,(20.4±2.1)points],and pain VAS score[(1.74±0.21)points,(2.12±0.26)points]in the two groups were lower than those before treatment[(4.4±0.5)°,(4.3±0.4)°;(32.8±3.3)%,(32.3±3.2)%;(23.7±2.4)°,(22.9±2.3)°;(62.1±6.4)points,(61.7±6.2)points;(5.40±0.57)points,(5.36±0.54)points;P<0.05],which were lower in the combination group than the control group(P<0.05).After treatment,the serum COR,MYO,LDH levels,and JOA score in two groups were higher than those before treatment(P<0.05),which were higher in the combination group than the control group(P<0.05).The total effective rate of the combination group was higher than that of the control group(98%vs.82%;P<0.05).After 12 months of follow-up,the complication rate in the combination group was lower than that in the control group(4%vs.22%;P<0.05).Conclusion Electroacupuncture combined with PEEK rod semi-rigid fixation is effective in the treatment of DLSS,which can significantly improve lumbar function,relieve pain,and has high safety.