经椎间孔椎体间融合术联合独活寄生汤加减治疗单间隙腰椎管狭窄症20例

目的 观察经椎间孔椎体间融合术联合独活寄生汤治疗单间隙腰椎管狭窄症的临床疗效。方法 将40例单间隙腰椎管狭窄症患者分为观察组和对照组，每组20例，两组均行经椎间孔椎体间融合术，仅观察组术后服用独活寄生汤，对比观测两组术后椎体高度、手术前后腰痛视觉模拟量表（visual analogue scale，VAS）评分和Oswestry生活功能障碍指数（Oswestry disability index，ODI）评分的差异。结果 各时点两组椎体前缘、中缘、后缘高度比较，差异均无统计学意义（P>0.05）。与术前比较，两组术后1个月椎体前缘、中缘、后缘高度均显著上升（P<0.05）；与术后1个月比较，术后3、6、12个月两组椎体前缘、中缘、后缘高度均逐渐降低。与术前比较，两组患者术后1、3、6、12个月腰痛程度VAS评分和ODI评分均逐渐降低（P<0.05）。与对照组比较，术后3、6个月观察组患者腰痛程度VAS评分均显著降低（P<0.05）；术后1、3、6、12个月观察组患者ODI评分均显著低于对照组（P<0.05）。结论 经椎间孔椎体间融合术联合独活寄生汤治疗单间隙腰椎管狭窄症，能显著缓解患者疼痛，改善腰椎功能。

Clinical Effect of Transforaminal Lumbar Interbody Fusion Combined with Modified Duhuo Jisheng Decoction in Treatment of Single-level Lumbar Spinal Stenosis

Objective To investigate the clinical effect of transforaminal lumbar interbody fusion combined with Duhuo Jisheng Decoction in the treatment of single-level lumbar spinal stenosis. Methods A total of 40 patients with single-level lumbar spinal stenosis were randomly divided into observation group and control group, with 20 patients in each group. Both groups were given transforaminal lumbar interbody fusion, and only the patients in the observation group were given Duhuo Jisheng Decoction after surgery. The two groups were compared in terms of vertebral height after surgery, Visual Analog Scale (VAS) score of low back and leg pain before and after surgery, and Oswestry Disability Index (ODI) score before and after surgery. Results There were no significant differences in the heights of the anterior, middle, and posterior borders of the vertebral body between the two groups at each time point (P>0.05). Both groups had significant increases in the heights of the anterior, middle, and posterior borders of the vertebral body at 1 month after surgery (P<0.05), followed by gradual reductions at 3, 6, and 12 months after surgery. Both groups had gradual reductions in the VAS score of low back pain and ODI score at 1, 3, 6, and 12 months after surgery (P<0.05). Compared with the control group, the observation group had a significant reduction in the VAS score of low back pain at 3 and 6 months after surgery (P<0.05). At 1, 3, 6, and 12 months after surgery, the observation group had a significantly lower ODI score than the control group (P<0.05). Conclusion In the treatment of single-level lumbar spinal stenosis, transforaminal lumbar interbody fusion combined with Duhuo Jisheng Decoction can significantly relieve pain and improve lumbar function.