Clinical Efficacy And Correlation Of Spinal And Pelvic Sagittal Imaging Parameters After LSS Assisted By Microchannel Microscopy

Objective To investigate the curative effect of bilateral Lumbar spinal canal decompression after treatment of single and double-segment spinal stenosis(LSS)assisted by unilateral microchannel microscope and the change of spinal-pelvic sagittal position parameters,and analyze the relationship between imaging parameters and the curative effect.In order to provide a new theoretical basis for the selection of surgical methods and prognosis of LSS and further improve the treatment system.Methods A total of 68 patients diagnosed with LSS and undergoing unilateral microchannel micromicroscope-assisted surgical treatment in the Spinal Surgery Department of Ordos Central Hospital from January 2021 to October 2022 were included.They were divided into single-segment group and double-segment group according to the level of surgical decompression.All patients were followed for more than 6 months after surgery.The VAS score(visual analogue scale)and Oswestry disability index(ODI)of the patients before surgery and at the last follow-up were collected,and the improvement rate was calculated.Lumbar spine measured Sagittal vertical axis(SVA),Thoracic kyphosis(TK),Lumbar lordosis(TK),and lumbar spine.LL),the Pelvic incidence(PI),the Sacral slope(SS),the Pelvic tilt(PT).The data were grouped and sorted,and the differences of each index were analyzed before surgery and at the last follow-up.Pearson correlation test was used to analyze the correlation between the value of spinal-pelvic sagittal position parameters and the improvement rate of leg VAS and ODI.Results All patients successfully completed the operation and were followed up for 6-12 months,with an average of(8.65±1.43)months,an average of(155.66±28.11)min,an average intraoperative blood loss of(37.41±12.22)m L,and an average length of hospital stay of(6.16±1.14)d.At the last follow-up,all patients had good lumbar stability and no surgical segment restenosis.SS,LL and TK were increased,PT and SVA were decreased,leg pain VAS score and ODI were improved(P<0.05)in all groups(single segment group + double segment group).PI,SS,LL and leg pain VAS in single-segment group were significantly lower than those in double-segment group,while SVA and TK were higher than those in double-segment group.There was no significant difference in ODI between the two groups before surgery,and the one-segment group was less than the two-segment group after surgery(P<0.05).Pearson product moment correlation analysis showed that PI,PT,SS and LL were significantly correlated in the single and double segment groups before surgery,and LL and SS were significantly correlated with ODI and leg pain VAS(P<0.05).There was a significant correlation between LL changes and ODI improvement rate in the single and double level groups,but no significant correlation between sagittal position parameters and the improvement rate of leg pain VAS in each group(P>0.05).The difference of SS,PT,LL,SVA,TK,VAS score and ODI before and after one-segment and two-segment surgery were compared between the two groups.The results showed that the difference of PT,TK,and VAS improvement rate of leg pain before and after surgery in the single-segment group was greater than that in the two-segment group,with statistical significance(P<0.05).Conclusion(1)Bilateral lumbar spinal canal decompression assisted by unilateral microchannel microscope in the treatment of LSS was effective and improved the parameters of spinal and pelvic sagittal position;(2)The improvement of spinal-pelvic sagittal plane parameters and the relief of leg pain and dysfunction in patients with single level LSS are better than those with double level LSS.