Clinical Efficacy Of Pedicle Screw Combined With PLIF Treatment Of Degenerative Lumbar Spinal Stenosis

Objective:To evaluate the clinical efficacy of pedicle screw fixation, laminectomy decompression combined with PLIF for the treatment of degenerative lumbar spinal stenosis, and to explore the pathogenesis of lumbar stenosis and relative merits of surgical operative treatment.Method:To investigate curative efficacy of surgery treatment of27selected cases in our hospital from April2012to December2013using pedicle screw fixation, laminectomy decompression combined with PLIF for the treatment of degenerative lumbar spinal stenosis. There were11male cases and16female cases, aged from49to73years old, averaged67.5years. Lesion segments:there were18cases (L3/4～L4/5),5cases (L4/5～L5/S1) and4cases (L3/4L5/S1), all of which were multi-segmental stenosis. According to the clinical manifestations before the surgery and the image features of those cases, the preoperative decompressed and fused levels were determined, and all of those cases were conducted with interbody fusion and pedicle screw fixation on the basis of decompression. The JOA and ODI scoring methods were adopted to evaluate the clinical efficacy. The X-ray of lumbar was taken in follow-up visits, from which the intervertebral space height, lumbar interbody fusion and stability conditions were observed.Results:27cases obtained4to15months of follow-up visits, averaging6.6months, and these patients’ postoperative conditions improved significantly. The JOA score improved from preoperative3.35±1.176points to12.75±1.433(P<0.05) after surgery, there were excellent in20cases (74.1%) and good in5cases (18.5%). That is the excellent rate reached92.62%. The ODI score improved from preoperative44.51±14.172%to22.57±9.875%(P<0.05) after surgery, and26patients (96.2%of the patients), whose quality of lives were significantly improved, they satisfied with the postoperative effect. The intervertebral fusion conditions of the cases in accordance to Toth statics, lumbar fusion Grade C were in15cases, accounting for55.5%, grade B were in9cases, accounting for33.3%, and grade A were3cases, accounting for11.2%. X-ray examination, indicated that cage location were good, with no significant shift or collapse, without iatrogenic instability of other complications, and no significant loss of intervertebral height.Conclusion:The operation of pedicle screw fixation, laminectomy decompression and posterior interbody cage between fusion (PLIF) in treating degenerative lumbar spinal stenosis is a safe and effective surgery method, which in full decompression, reconstruct of spinal stability and improve patients’healthy condition and quality of life.