椎间孔镜联合棘突间融合治疗老年人腰椎管狭窄症伴不稳

目的:观察椎间孔镜联合棘突间融合术治疗老年人腰椎管狭窄症伴不稳的临床疗效.方法:2018年2月至2019年2月诊治82例老年人腰椎管狭窄症伴不稳患者,分为对照组与观察组.对照组41例患者中男23例,女18例;年龄(68.9±4.1)岁;病程(14.1±5.7)个月;单节段病变5例,多节段病变36例;运用单纯Bacfus...

Clinical observation of transforaminal endoscopy combined with interspinous fusion in the treatment of lumbar spinal stenosis with instability in the elderly

Objective: To observe the clinical effect of transforaminal endoscopy combined with interspinous fusion in the treatment of lumbar spinal stenosis with instability in the elderly.Methods: From February 2018 to February 2019,82 elderly patients with lumbar spinal stenosis and instability were divided into control group and observation group. In the control group,there were 23 males and 18 females;the age was (68.9±4.1) years;the course of disease was (14.1±5.7) months;there were 5 cases of single segment lesions and 36 cases of multi segment lesions;simple bacfuse interspinous fusion was used. In the observation group,there were 22 males and 19 females;the age was(69.1±4.0) years;the course of disease was(14.4±5.5) months;there were 6 cases of single segment lesions and 35 cases of multi segment lesions;they were treated with transforaminal endoscopic surgery combined with Bacfuse interspinous fusion. The clinical efficacy,visual analogue scale(VAS),Japanese Orthopaedic Association scores(JOA),Oswestry disability index(ODI),Lehmann lumbar function score,posterior disc height and intervertebral foramen height,complication rate and recurrence rate of the two groups were compared.Results: The clinical efficacy of the observation group was better than that of the control group;the VAS score of the observation group was lower than that of the control group,the JOA score was higher than that of the control group,and the ODI index at 3 months after operation and at the last follow-up was lower than that of the control group,the Lehmann lumbar function score was higher than that of the control group;the posterior edge height of intervertebral disc and intervertebral foramen height were higher than those of the control group;the incidence of complications and recurrence rate(4.9% and 0.0%) of the observation group were lower than those of the control group(19.5%,9.8%),the difference was statistically significant(P<0.05).Conclusion: The clinical effect of transforaminal endoscopy combined with interspinous process fusion in the treatment of lumbar spinal stenosis with instability in the elderly is ideal. It can reduce postoperative pain,improve lumbar function,improve the height of posterior edge of intervertebral disc and intervertebral foramen,and reduce the incidence and recurrence rate. It is worthy of clinical promotion.