| Objective: Based on the theory of "Kidney Deficiency And Bone Impotence",to investigate the quality of lumbar interbody fusion after posterior lumbar fusion for the treatment of senile lumbar degenerative diseases(including the Lumbar spinal stenosis,Lumbar disc herniation,Lumbar spondylolisthesis)and the clinical effect of Xianling Gubao capsule,to observe the difference of clinical fusion quality,and to provide reference for clinical postoperative rehabilitation.Methods: 1.According to the inclusion criteria,collected in October 2018-October2020 in Spinal Department,Affiliated Hospital of Shandong University of Traditional Chinese Medicine to posterior lumbar spinal canal decompression intervertebral bone graft fusion surgery in elderly patients with lumbar degenerative disease cases,autogenous bone and allogeneic bone,bone mass normal and osteoporosis,single segment and double segmental of these three factors as the research object.A total of 160 patients were selected and divided into four groups: single segment+autogenous bone+normal bone(group A),single segment+autogenous bone mixed allogeneic bone+normal bone(group B),single segment+autogenous bone+osteoporosis(group C),and double segment+autogenous bone+normal bone(group D),with 40 patients in each group.Follow-up was at least 12 months.All patients have an operation on lumbar posterior spinal decompression and interbody bone grafting and fusion.The operative time,intraoperative blood loss and length of hospital stay of patients in four groups were recorded.VAS and ODI scores were evaluated before surgery,3 days after surgery,1 month after surgery,3 months after surgery,6 months after surgery,and 1 year after surgery by outpatient follow-up.Interbody fusion rates of patients in each group were recorded 3 months,6 months and 12 months after surgery by CT fusion evaluation indexes.SPSS26.0 statistical software was used to compare and analyze the data of the four groups to evaluate the influence of PLIF in the treatment of senile lumbar degenerative diseases under different factors on the quality of postoperative lumbar interbody fusion.2.Eighty PLIF patients with single segment + autogenous bone + osteoporosis were randomly divided into control group and Xianling Gubao group.Both groups were also given calcium carbonate D3 treatment,and Xianling Gubao group was combined with Xianling Gubao capsule on the basis of control group.The vas and ODI scores of the two groups before operation,3 months after operation,6 months after operation and 12 months after operation were recorded respectively.The intervertebral fusion rate of the two groups at 3 months,6 months and 12 months after operation was recorded to explore the clinical effect of Xianling Gubao Capsule on patients with osteoporosis after PLIF operation.Result:1.Clinical Review:(1)There was no significant difference in hospital stay among the four groups(P>0.05);A.There was no significant difference in operation time and intraoperative bleeding between groups B and C(P>0.05);The operation time and intraoperative bleeding in group A were less than those in group D(P<0.05).(2)Comparison of vas and ODI scores:(1)comparison between groups: there was no significant difference in VAS and ODI scores before operation,6 months and 12 months after operation among the four groups(P>0.05);(2)Intra group comparison: the vas and ODI scores of the four groups at 3 months after operation were better than those before operation,and the vas and ODI scores at 6 months after operation were better than those at3 months after operation(P<0.05);There was no significant difference in VAS and ODI scores between 6 months and 12 months after operation(P>0.05).(3)Comparison of fusion rates:(1)Comparison of A and B groups: interbody fusion rates in group A were higher than those in group B at 3 and 6 months after surgery,with statistical differences(P<0.05),there was no significant difference in the fusion rate between the two groups 12 months after surgery(P>0.05);(2)Comparison between group A and group C: the rate of interbody fusion in group A was higher than that in group C at 3,6 and 12 months after surgery,with statistical difference(P<0.05);(3)Comparison between group A and group D: the rate of interbody fusion in group A was higher than that in group D at 3,6 and 12 months after surgery,with statistical difference(P<0.05).2.Drug intervention:(1)Comparison of vas and ODI scores:(1)comparison between groups: the vas and ODI scores of Xianlinggubao group at 3,6 and 12 months after operation were better than those of the control group,and the difference was statistically significant(P<0.05);(2)Intra group comparison: the vas and ODI scores of the two groups at 3 months after operation were better than those before operation,and the vas and ODI scores at 6 months after operation were better than those at 3 months after operation(P<0.05);There was no significant difference in VAS and ODI scores between 6 months and 12 months after operation(P>0.05).(2)Comparison of fusion rates: the interbody fusion rates in Xianling Gubao group were higher than those in the control group at 3months,6 months and 12 months after surgery,with statistical differences(P<0.05).(3)Evaluation of TCM syndrome efficacy: the effective rate of TCM syndrome in Xianling Gubao group was higher than that in control group,with statistical difference(P<0.05).Conclusion:1.Clinical review: For elderly patients with degenerative lumbar diseases,allogeneic bone,osteoporosis and double segment all affect the time and quality of lumbar interbody fusion after PLIF surgery to varying degrees.For patients with mixed implantation of allogeneic bone and double-segment surgery,the wearing time of the brace should be appropriately extended,the number of follow-up visits should be increased,and the follow-up time should be extended.Shorten the time of bone graft fusion,promote bone graft fusion,improve the rate of bone graft fusion,and achieve the long-term therapeutic effect of bone fusion.2.Drug intervention: 2.Drug intervention: Under the guidance of the theory of“Kidney Deficiency And Bone Impotence",for patients with osteoporosis undergoing PLIF surgery,the combined application of Xianling Gubao capsule can accelerate the fusion time,increase the rate of intervertebral bone graft fusion,and achieve better clinical efficacy. |
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