摘要
Abstract
Objective To investigate the efficacy of minimally invasive foraminotomy and decompression for the single-segment lumbar spinal stenosis(LSS),and to analyze the influencing factors for its prognosis during the 2 years of follow-up.Methods A total of 104 patients with single-segment LSS diagnosed and treated at the People's Hospital of Inner Mongolia Autonomous Region from January 2019 to June 2022 were retrospectively recruited for analyses.Patients were divided into the control group(n=46)and observation group(n=58)according to the treatment method.Traditional posterior lumbar laminectomy and fusion were performed in the control group,while the minimally invasive foraminotomy and decompression were performed in the observation group.Surgery-related indicators,and the Oswestry Disability Index(ODI),and Visual Analog Scale(VAS)scores before and 1 day,1 year and 2 years after the surgery were compared between the two groups.At the 2 years of follow-up,patients were divided into the good prognosis group(n=81)and poor prognosis group(n=23)based on the 2-year follow-up prognosis.Multivariate logistic regression analysis was used to analyze the influencing factors for the prognosis.Results Patients in the observation group had significantly less intraoperative blood loss,shorter operation time and length of hospital stay,and shorter incision length compared to the control group(all P<0.05).The ODI scores at 1 day,1 year and 2 years postoperatively were significantly reduced in both groups,which were significantly lower in the observation group than the control group(P<0.05).The VAS scores for the lumbar and legs at 1 day,1 year and 2 years postoperatively were significantly reduced in both groups,which were significantly lower in the observation group than the control group(P<0.05).The total incidence of postoperative complications in the observation group was significantly lower than the control group(5.17%[3/58]vs.17.39%[8/46],χ2=4.050,P=0.044).At the 2-year follow-up,the excellent and good rate of the modified MacNab criteria was significantly higher in the observation group than the control group(P<0.05).Multivariate analysis showed that the degree of spinal stenosis,treatment method,postoperative brace use,and wound infection were influencing factors for the 2-year prognosis of single-segment LSS(P<0.05).Conclusion Minimally invasive foraminotomy and decompression are more effective in treating single-segment LSS compared to traditional posterior lumbar laminectomy and fusion.The degree of spinal stenosis,treatment method,postoperative brace use,and wound infection are influencing factors for the 2-year prognosis of single-segment LSS.关键词
经皮椎间孔镜减压术/腰椎管狭窄症/单节段/疗效/预后Key words
Minimally invasive foraminotomy and decompression/Lumbar spinal stenosis/Single-segment/Efficacy/Prognosis分类
临床医学
