The Analysis Of The Influential Factors Of Outcomes And Prognosis Of Surgical Treatment Of Thoracolumbar Spinal Stenosis

ObjectiveA retrospective study of 27 cases of thoracolumbar spinal stenosis(T10-L2)patients and to evaluate the factors influencing the efficacy of the operation and nerve function after surgery.MethodsA retrospective analysis of clinical data of China Japan Union Hospital of Jilin University during November 2016 to January 2013 27 cases of thoracolumbar spinal stenosis.The spinal cord function was assessed by JOA spinal cord injury score(29 score)and the ASIA classification in the United States before and after the first week and the last follow-up.The recovery rate of JOA was calculated to assess the efficacy of surgery,postoperative or nerve symptoms and its influencing factors,the related factors were analyzed by logistic regression analysis,and to observe whether the complication of cerebrospinal fluid leakage.Result:Twenty-seven patients(10 males and 17 females)underwent thoracolumbar posterior decompression and bone graft fusion.Age(18-82)years old,age group(55.29 ± 20.806)years old,non-aggravated group(53.50(2.12 ± 28.112)months;the average preoperative JOA score was increased(5.57 ± 28.485 months),the mean duration of the preoperative JOA score(5.57 ± 28.485 months)(10.25 ± 2.552)points,and the follow-up time was 6-36 months(mean,18.37 months).There were 19 cases(70.37%)with excellent improvement rate of JOA score,4 cases(14.81%)and 4 cases(14.81%)without change.Seven patients had increased spinal cord injury after operation,6 cases had symptomatic and rehabilitation,and recovered from 2 weeks to 3 months after operation.One patient had no recovery at the last follow-up(18 months).Multivariate logistic regression analysis showed that the preoperative JOA score was statistically significant for patients with postoperative spinal cord injury after operation time,bleeding volume,preoperative JOA score and other related factors.Conclusion:Surgical treatment of thoracolumbar vertebral canal is a effective treatment for stenosis,although the risk of spinal cord injury has certain function after operation.However,most of the spinal cord function can be recovered after treatment with hormone shock,dehydration and rehabilitation.Early diagnosis and surgical treatment and preoperative JOA score of treatment and prognosis of thoracolumbar spinal stenosis plays an important role.Preoperative JOA score was correlated with postoperative symptom exacerbation.