Application Of Selective Nerve Root Sealing In Atypical Symptoms And Multi-level Lumbar Degeneration

Purpose: To compare the efficacy of limited lumbar decompression followed by selective nerve root closure before surgery and traditional extended lumbar decompression in patients with atypical symptoms and multilevel lumbar degenerative diseasesMethods: We selected patients with atypical symptoms or multilevel lumbar degenerative diseases of the lumbar spine from December 2017 to December 2019 in our department,of which group A(selective nerve root sealing group)before surgery Nerve root closure was performed to determine the responsible segment and then spinal canal decompression of the corresponding segment was performed.A total of 34 cases were performed,with an average age of 56.6 years;group B(traditional surgery group) performed multi-segment lumbar spine according to neurological examination and imaging findings Tube decompression surgery.The visual analogue scale(VAS)score and Oswestry dysfunction index(ODI)were evaluated preoperatively,and the VAS pain score,ODI dysfunction index and lumbar DR were followed up for 1 month and 1 year after surgery.Then calculate the VAS improvement rate(VAS improvement rate=(preoperative VAS-postoperative VAS)/preoperative VAS)and ODI improvement of the two groups of VAS pain score and ODI dysfunction index 1 month and 1 year after operation.Rate(improvement rate of postoperative ODI=(preoperative ODI-postoperative ODI)/preoperative ODI),statistically analyzed by SPSS20.0 statistical software,respectively 1.The data in the two groups were compared 1 month after surgery and 1 month after surgery Whether the difference between the annual VAS pain score and the preoperative VAS pain score is statistically significant,and whether the difference in the VAS pain score between the two groups is statistically significant;the two groups have improved VAS pain scores at 1 month and 1 year after surgery Whether there is a statistical difference in the rate,and whether there is a statistical difference in the improvement rate of the VAS pain score between the two groups;2.The difference between the ODI dysfunction index and the preoperative ODI dysfunction index at 1 month and 1 year after the operation in the two groups Whether it is statistically significant,and whether the difference in the ODI dysfunction index between the two groups is statistically significant;whether there is a statistical difference in the ODI dysfunction index improvement rate between the two groups at 1 month and 1 year after the operation.Whether the improvement rate of dysfunction index is statistically different.Results:According to preoperative imaging findings,patients in group A had a total of 77 segmental stenosis,an average of 2.3 segments/person;preoperative nerve root sealing followed by limited spinal canal decompression,a total of 53 segments,an average of 1.6segments/person People;compared with the preoperative average number of segments reduced by 30.4%.The VAS pain scores of group A and group B decreased significantly at 1 month,1 year after operation and before operation,and the improvement rate of VAS pain score at 1 month after operation in group A and B was different from the improvement rate of VAS pain score at 1 year after operation.There was statistical significance(P<0.05),but the VAS pain score improvement rate in group A at 1 month and 1 year after surgery was not statistically different from the VAS pain score improvement rate in group B at 1 month and 1 year after surgery(P >0.05).The ODI dysfunction index and the preoperative ODI dysfunction index scores of group A and group B at 1 month and 1 year after operation and the preoperative ODI dysfunction index scores showed significant improvement,and the improvement rate of ODI index in group A and group B at 1 month after operation and the ODI index at 1 year The improvement rate data difference was statistically significant(P<0.05),but the ODI index improvement rate of group A at 1 month and 1 year after surgery was not statistically different from that of group B at 1 month and 1 year after surgery.(P>0.05).Conclusions: For patients with atypical symptoms and multi-segment degenerative diseases of the lumbar spine,the limited lumbar spinal canal decompression at the responsible segment through selective nerve root sealing can not only achieve the surgical effect of traditional lumbar spinal decompression,but also Can reduce the patient’s surgical risk.