The Study Of The Clinical Effect Of Posterior Short Segment Decompression And Internal Fixation In The Treatment Of Degenerative Lumbar Scoliosis Based On The Theory Of "Rebalanced Muscles And Bones"

Objective: to investigate and compare the effect of posterior short segment decompression and internal fixation in the treatment of degenerative lumbar scoliosis based on the theory of "rebalanced muscles and bones" and further to debate the occurrence and development of degenerative lumbar lateral curvature,diagnosis,treatment,prognosis,and surgery characteristics,and to provide reference for clinical treatment options in the future.Methods: According to the inclusion criteria,40 patients with degenerative lumbar scoliosis were selected who are admitted by the Department of Orthopedics of our hospital from January 2016 to January 2019.According to the different surgical methods,the patientsweredividedintotwo groups:Inone group,20 patientsweretreatedwithposterior shortsegmentdecompressionand internalfixation(observationgroup),intheother group,20 patients with posterior long segment decompression and internal fixation(control group).There were 6 males and 14 females in the observation group,aged 60.45±8.82 years.In the control group,there were 20 patients,including 4 males and 16 females,aged 64.00±9.00 years.The spinal internal fixation system provided by Shandong Kangsheng Medical Instrument Co.,Ltd was used as the surgical materials for both groups.Intraoperative blood loss,operative time,postoperative complications and length of stay were recorded in 2 groups.Preoperative and postoperative imaging indicators(including Cobb Angle of lumbar scoliosis,apical displacement,sagittal plane imbalance of the whole spine,lumbar lordosis);Visual analogue scale(VAS)and Oswestry disability index(ODI)were used before surgery,1 month after surgery,3 months after surgery,and 1 year after surgery.Results:1.Efficacy evaluation:(1)After treatment,the modified Mac NAB efficacy grading method was used to evaluate the overall postoperative effect,and both groups of patients were satisfied with the surgical effect,the difference was not statistically significant(P>0.05).(2)Intra-group comparison between the two groups showed significant improvement after treatment compared with before operation in VAS score,ODI score,lumbar scoliosis Cobb Angle,apical vertebral displacement,sagittal plane imbalance value of the whole spine,and lumbar lordosis Angle,and the differences showed statistical significance(P<0.05);In terms of VAS score and ODI score,the differences were statistically significant 3 months and 1 year after treatment compared with 1 month after treatment(P<0.05).(3)Comparison between the two groups of patients showed statistically significant difference in operative time,intraoperative blood loss and length of stay(P<0.05);The VAS score,ODI score,the improvement rate of Cobb Angle,apical displacement,sagittal plane imbalance of the whole spine,and lordosis Angle of the lumbar spine were compared at 1 month,3 months and 1 year after surgery,and the differences were not statistically significant(P>0.05).2.Safety indicators: The operation was successful in both groups,and there were no intraoperative misplacement of pedicle screws or improper position of interbody fusion device.Two groups of patients had good postoperative incisions and Grade A healing.No complications such as pulmonary embolism and deep venous thrombosis occurred in 2 groups.Conclusion: 1.Compared with posterior long segment decompression and internal fixation,posterior short segment decompression and internal fixation in the treatment ofdegenerativelumbarscoliosis hasshorteroperationtime,smalltrauma,lessblood loss,and shorter hospitalization time.And the short-term and long-term effects of the two surgical methods were similar.The efficacy has been affirmed in improving patients’ pain,correcting scoliosis deformity and improving quality of life,which has brought good news to some elderly patients.2.Withthetheoryof "rebalancedmusclesandbones",payattentiontothecoordination of muscle and bone,not for the purpose of fully anatomic orthopaedic,through short segmental decompression fixed new bones and muscles in order to achieve balance methods in the treatment of degenerative lumbar lateral curvature,reduces the long segmental decompression and internal fixation surgery to the destruction of the brawn organization,pay attention to the protection of the tendons,bone,as far as possible to maintain the muscles,bones,blood vessels and nerves within the overall balance,pay more attention to the integrity and stability of the spine,curative effect is remarkable.