骨水泥强化椎弓根钉内固定手术对老年退行性腰椎管狭窄症患者腰椎功能及并发症的影响

Effect of Bone Cement-Enhanced Pedicle Nail Internal Fixation on Lumbar Function and Complications in Elderly Patients with Degenerative Lumbar Spinal Stenosis

目的:探讨骨水泥强化椎弓根钉内固定手术对老年退行性腰椎管狭窄症(DLSS)患者腰椎功能及并发症的影响。方法:选择2021年8月—2023年9月兰陵县人民医院收治的82例老年DLSS患者为研究对象,按随机数字表法将其分为研究组和对照组,各41例。对照组采用常规椎弓根钉内固定手术治疗,研究组采用骨水泥强化椎弓根钉内固定手术治疗。对比两组的围手术期指标、疼痛程度、腰椎功能、生活质量、并发症发生情况。结果:研究组手术时间长于对照组,差异有统计学意义(P<0.05)。术后8个月,研究组疼痛视觉模拟评分法、Oswestry功能障碍指数评分均低于对照组,生活质量综合评定问卷-74各个维度评分均高于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为4.88%,低于对照组的19.51%,差异有统计学意义(P<0.05)。两组术中、术后出血量比较,差异均无统计学意义(P>0.05)。结论:骨水泥强化椎弓根钉内固定手术应用于老年DLSS患者的治疗中能有效缓解腰部的疼痛感,改善患者的腰椎功能,提高生活质量,且并发症较少。

Objective:To investigate the effects of bone cement-enhanced pedicle nail internal fixation on lumbar function and complications in elderly patients with degenerative lumbar spinal stenosis(DLSS).Methods:A total of 82 elderly patients with DLSS treated in Lanling County People’s Hospital from August 2021 to September 2023 were selected as the study objects,and were divided into a study group and a control group according to random number table method,with 41 cases in each group.The control group was treated with conventional pedicle nail internal fixation,and the study group was treated with bone cement-enhanced pedicle nail internal fixation.Perioperative indexes,pain degree,lumbar spine function,quality of life and the occurence of complications were compared between the two groups.Results:The operation time of the study group was longer than that of the control group,and the difference was statistically significant(P<0.05).At 8 months after surgery,the pain Visual of analogue Scale score and Oswestry Disability Index scores of the study group were lower than those of the control group,and the scores of all dimensions of the Generic Quality of Life Inventory-74 were higher than those of the control group,with statistical significance(P<0.05).The complication rate of the study group was 4.88%,which was lower than 19.51%of the control group,the difference was statistically significant(P<0.05).There were no significant differences in intraoperative and postoperative blood loss between the two groups(P>0.05).Conclusion:The application of bone cement-enhanced pedicle nail internal fixation in the treatment of elderly DLSS patients can effectively relieve the pain of the lumbar spine,improve the function of the lumbar spine,improve the quality of life of patients,and have fewer complications.