Clinical Analysis Of Treatment For Degeneration Of Lumbar Vertebra By Microsurgical Nerve Root Decompression And The Anatomic Investigation

Part one Analysis of Treatment for the Degeneration of Lumbar Vertebra by Total Laminectomy or Microsurgical Nerve Root DecompressionObjectiveTo compare the clinical results, advantages and disadvantages of the degeneration of lumbar vertebra patients with the treatment of microsurgical nerve root decompression or Total Laminectomy.MethodsThe Eighty seven cases operated with the degeneration of lumbar vertebra were analyzed from2000to2012, among them,38cases operated with Total Laminectomy and49cases operated with microsurgical nerve root decompression. The operating time, blood loss, duration of hospitalization after operation, joa before and after surgery were compared.ResultsOne month after surgery,there is no Significant difference between the microsurgical nerve root decompression group and the total laminectomy group.two years after surgical, there are Significant differences between the microsurgical nerve root decompression group and the total laminectomy group. And with the postoperative sciatica relief, significant differences could be observed in blood loss, duration of hospitalization after operation and postoperative visual analog scales. There is no significant differences in the operation time.ConclusionThe symptoms of the the degeneration of lumbar vertebra can be reliefed effectively by both methods, but microsurgical nerve root decompression has more advantages of less trauma, less blood loss, earlier rehabilitation, less postoperative low back pain. In the early and mid-efficacy,the latter is superior to the former. Part twoLumbar anatomic parameter measurement and its clinical significance of microsurgical nerve root decompressionObjectiveTo investigate the anatomic basis of microsurgical nerve root decompression in order to accurately locate the nerve root position and improve the treating result.MethodsTwenty intact lumbar spines were anatomized in adult cadavers.we resected the distal attachment using the surgical approach, exposed the nerve root. The anatomical relationship between nerve root and the articular process, the vertebral plate,the intervertebral disc, the length of the nerve root, the angle of the nerve root were measured respectively.ResultsThere were no gender differences in the relationship of nerve root and surrounding anatomic structures, the length of nerve root and the angle of the nerve root. There was significant difference in different levels of lumbar spine.ConclusionThe experimental data could be referenced by the surgery. The location of the nerve root could be positioned by anatomic markers. We retained normal anatomical structures and the stability of the spine on the basis of thoroughly decompression.